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Drug-drug interactions (DDIs) present a significant health burden, compounded by clinician time constraints and poor patient health literacy. We assessed the ability of ChatGPT (generative artificial intelligence-based large language model) to predict DDIs in a real-world setting. Demographics, diagnoses and prescribed medicines for 120 hospitalized patients were input through three standardized prompts to ChatGPT version 3.5 and compared against pharmacist DDI evaluation to estimate diagnostic accuracy. Area under receiver operating characteristic and inter-rater reliability (Cohen's and Fleiss' kappa coefficients) were calculated. ChatGPT's responses differed based on prompt wording style, with higher sensitivity for prompts mentioning 'drug interaction'. Confusion matrices displayed low true positive and high true negative rates, and there was minimal agreement between ChatGPT and pharmacists (Cohen's kappa values 0.077-0.143). Low sensitivity values suggest a lack of success in identifying DDIs by ChatGPT, and further development is required before it can reliably assess potential DDIs in real-world scenarios., (© 2024 The Author(s). British Journal of Clinical Pharmacology published by John Wiley & Sons Ltd on behalf of British Pharmacological Society.)

Objective: With the surge of confirmed cases of coronavirus disease 2019 (COVID-19) and its associated morbidities and mortalities, continuous companion support during labour was halted in all public hospitals in Hong Kong to prevent the spread of the virus in hospitals. The purpose of this retrospective study was to evaluate the effect of not having continuous companion support during labour on pregnancy and neonatal outcomes during the COVID-19 pandemic period in a regional hospital., Study Design: We retrieved information on women without continuous companion support during the COVID-19 pandemic period from February 1, 2020 to May 15, 2020 and those with continuous companion support within the same period in 2019 in Queen Mary Hospital, Hong Kong. The pregnancy and neonatal outcomes were compared between the two groups., Results: A total of 446 women with continuous companion support in 2019 and 340 women without continuous companion support in 2020 were included in the analysis. The rate of labour augmentation was significantly lower in women with continuous companion support than in those without continuous companion support (3.1% vs. 6.5%, respectively, p = 0.027). Babies born to women with continuous companion support were less likely to have Apgar scores <7 at 1 min than those born to women without continuous companion support (2.5% vs. 5.3%, respectively, p = 0.036). More women with continuous companion support had breastfeeding at the first hour of delivery than those without (86.3% vs. 80.6%, respectively, p = 0.030). There were no differences in other pregnancy and neonatal outcomes. The subgroup analysis with only Chinese women showed that the pregnancy and neonatal outcomes were not significantly different between the two groups., Conclusion: Women without continuous companion support during labour had an increased chance of labour augmentation and babies with an Apgar score <7 at 1 min, and a reduced immediate breastfeeding rate when compared with those with continuous companion support., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

We compute the hadronic light-by-light scattering contribution to the muon g - 2 from the charm quark using lattice QCD. The calculation is performed on ensembles generated with dynamical ( u ,  d ,  s ) quarks at the SU(3) f symmetric point with degenerate pion and kaon masses of around 415 MeV. It includes the connected charm contribution, as well as the leading disconnected Wick contraction, involving the correlation between a charm and a light-quark loop. Cutoff effects turn out to be sizeable, which leads us to use lighter-than-physical charm masses, to employ a broad range of lattice spacings reaching down to 0.039 fm and to perform a combined charm-mass and continuum extrapolation. We use the η c meson to define the physical charm-mass point and obtain a final value of a μ HLbL , c = ( 2.8 ± 0.5 ) × 10 - 11 , whose uncertainty is dominated by the systematics of the extrapolation. Our result is consistent with the estimate based on a simple charm-quark loop, whilst being free of any perturbative scheme dependence on the charm mass. The mixed charm-light disconnected contraction contributes a small negative amount to the final value., (© The Author(s) 2022.)

Background: The aim of the International Academy of Cytology Yokohama System for Reporting Breast Fine Needle Aspiration Biopsy Cytopathology is to improve cytology practice. This study assessed cytologic diagnoses made with the system and its efficacy when it was applied by pathologists with different levels of experience., Methods: In all, 1080 cases of breast fine-needle aspiration biopsy (FNAB) over a period of 16 years were reviewed and reclassified with the system. The category distribution and the diagnostic performance were compared with the original diagnoses. The concordance rates for diagnoses from pathologists with different levels of experience were also determined., Results: The distribution of cytologic diagnoses made with the system was as follows: 11.7% were insufficient, 56.6% were benign, 20.1% were atypical, 6.1% were suspicious for malignancy, and 5.6% were malignant. The rates for the insufficient and atypical categories were lower than the original diagnosis rates (13.1% and 23.8%, respectively). Overall, 120 cases (11.1%) were recategorized. Among those recategorized as benign, suspicious, or malignant with follow-up data, 96.7% were correctly reclassified. A significant improvement in diagnostic performance was found with the system (P < .001). Such improvement was also seen in problematic breast lesions, including fibroepithelial lesions, papillary lesions, and low-grade carcinomas. Pathologists with intermediate experience showed a higher concordance with an expert pathologist in the diagnoses than those with short experience (κ, 0.838 vs 0.634)., Conclusions: The system effectively categorized the diagnoses, and the diagnostic performance of FNAB reporting was improved. The structured reporting also enhanced the reproducibility of reporting by pathologists with intermediate experience and, to some extent, those with short experience., (© 2021 American Cancer Society.)

Background: We aimed to evaluate the effectiveness of PAE in weaning of catheter and relieving obstructive urinary symptoms in patients with acute urinary retention (AUR) due to benign prostatic hypertrophy (BPH) and failed trial without catheter (TWOC)., Materials and Methods: In this prospective study approved by the institutional review board, a signed informed consent was obtained. Eighteen consecutive patients with AUR due to BPH and failed TWOC were recruited. Nineteen consecutive patients with BPH but without AUR were recruited as a control. Patients with CTA evidence of arterial occlusion or significant stenosis along the prostate artery access path were excluded. PAE was performed using microspheres (100-300 μm diameter). Outcome assessment included successful weaning of catheter in 2 weeks, procedure-related complications, change of symptomatology and urodynamic findings at 1 month as compared to baseline, percent non-perfused prostate volume, and prostate volume reduction on MRI at 2 weeks., Results: Two patients in the study group and four in the control group were excluded due to arterial pathology. Embolization of bilateral prostate arteries was achieved in all patients in both the groups (100%). There was no complication. The catheter was successfully weaned in 87.5% (14/16) of patients within 14 days in the treatment group. There was no significant difference in patient demographics, prostate characteristics, and all outcome assessment parameters between both the groups., Conclusions: PAE was probably safe and effective in weaning of catheter and relieving obstructive urinary symptoms in patients due to BPH, with treatment outcomes comparable to those without AUR., Competing Interests: Compliance of Ethical Standards Conflict of interest On behalf of all authors, the corresponding author states that there is no conflict of interest for all the authors. Ethical Approval This study has been approved by NTEC-CUHK Clinical Research Ethics Committee. Informed Consent A signed informed consent was obtained from all patients.

In this study, we demonstrate a compact imaging spectroscopic system for high-throughput detection of biomolecular interactions on plasmonic chips, based on a curved grating as the key element of light diffraction and light focusing. Both the curved grating and the plasmonic chips are fabricated on flexible plastic substrates using a gas-assisted thermal-embossing method. A fiber-coupled broadband light source and a camera are included in the system. Spectral resolution within 1 nm is achieved in sensing environmental index solutions and protein bindings. The detected sensitivities of the plasmonic chip are comparable with a commercial spectrometer. An extra one-dimensional scanning stage enables high-throughput detection of protein binding on a designed plasmonic chip consisting of several nanoslit arrays with different periods. The detected resonance wavelengths match well with the grating equation under an air environment. Wavelength shifts between 1 and 9 nm are detected for antigens of various concentrations binding with antibodies. A simple, mass-productive and cost-effective method has been demonstrated on the imaging spectroscopic system for real-time, label-free, highly sensitive and high-throughput screening of biomolecular interactions.

The widespread and intensive use of neonicotinoid insecticides induces negative cascading effects on ecosystems. It is desirable to develop a portable sensitive sensing platform for on-site screening of high-risk pesticides. We combined an indirect competitive immunoassay, highly sensitive surface plasmon resonance (SPR) biochip and a simple portable imaging setup for label-free detection of imidacloprid pesticides. The SPR biochip consists of several capped nanoslit arrays with different periods which form a spectral image on the chip. The qualitative and semiquantitative analyses of pesticides can be directly observed from the spot shift on the chip. The precise semiquantitative analyses can be further completed by using image processing in a smartphone. We demonstrate simultaneous detection of four different concentrations of imidacloprid pesticides. The visual detection limit is about 1ppb, which is well below the maximum residue concentration permitted by law (20ppb). Compared to the one-step strip assay, the proposed chip is capable of performing semiquantitative analyses and multiple detection. Compared to the enzyme-linked immunosorbent assay, our method is label-free and requires simple washing steps and short reaction time. In addition, the label-free chip has a comparable sensitivity but wider working range than those labeling techniques., (Copyright © 2015 Elsevier B.V. All rights reserved.)

Study Design: Cohort study., Objective: To investigate the diagnostic capability of low-field magnetic resonance imaging (MRI) compared with high-field MRI for degenerative disease of the lumbar spine., Summary of Background Data: Low-field MRI has several advantages over high-field magnetic resonance systems (easier installation, lower purchase, and maintenance cost). The diagnostic capability of low-field MRI for degenerative disease of the lumbar spine has not been compared with that of high-field MRI., Methods: Hundred patients (mean age: 56.3 yr, range: 32-80; F:M = 59:41) with neurogenic claudication or sciatica were studied. All patients underwent MRI of the lumbar spine on both low-field (0.25T) and high-field (1.5T or 3.0T) magnetic resonance systems. Intervertebral disc herniation, central canal, lateral recess, and exit foraminal stenosis as well as nerve root compression at L3-L4, L4-L5, and L5-S1 were evaluated by 2 radiologists for both low- and high-field systems using established reliable grading systems., Results: There was excellent agreement between low- and high- field MRI with regard to grading the presence and severity of disc herniation (r = 0.92-0.94; P < 0.05), central canal stenosis (r = 0.89-0.91; P < 0.05), lateral recess stenosis (r = 0.81-0.87; P < 0.05), and exit foramen stenosis (r = 0.81-0.89; P < 0.05). Descending or exiting nerve root compression occurred in 52% of patients at L3-L4, L4-L5, or L5-S1 levels, with good agreement between low-field and high-field MRI (r = 0.71-0.76; P < 0.05) for nerve root compression., Conclusion: Excellent reliability between low- and high- field MRI was found for most features of lumbar disc degeneration, with good agreement for nerve root compression. 0.25T MRI was more susceptible to motion artifact, probably due to longer scanning time., Level of Evidence: 3.

Purpose: Idiopathic spontaneous intraperitoneal haemorrhage (ISIH), historically known as abdominal apoplexy, is spontaneous haemorrhage due to rupture of an intra-abdominal visceral vessel in the absence of trauma or underlying pathology. It is an exceptionally rare condition, with mostly scattered case reports available. The aim of this study was to describe this rare condition, possible associated risk factors, and usefulness of multislice-CT (MS-CT) angiogram in its diagnosis prior to intervention., Methods: A retrospective review of patients diagnosed with ISIH. Radiological records of haemoperitoneum from a single tertiary hospital in 2006-2013 were analysed, and the cases of ISIH were identified. Demographics (including pre-morbid hypertension status), abdominal aortic calcification as a measure of atherosclerotic changes, MS-CT angiogram +/- conventional digital subtraction angiograph images, surgical records and outcomes were reviewed., Results: 425 cases of haemoperitoneum were retrieved from hospital radiology database from 2006 to 2013, and 5 patients (1.1%) diagnosed with ISIH were identified (4 males, 1 female, mean age of 64 years). 4 out of 5 patients (80%) had a history of hypertension (mean 150/90 mmHg) and 3 patients had moderate abdominal aortic atherosclerosis. MS-CT angiogram was able to diagnose the bleeding source in 4 out of 5 patients, while the bleeding source remained occult in the last patient even with both MS-CT and traditional DSA angiography. Patients who underwent either embolization or surgery had no further re-bleeding in clinical follow up, ranging from 5 to 8 years., Conclusions: Hypertension and abdominal aortic atherosclerosis appear to be associated risk factors for ISIH, and MS-CT angiogram has a high sensitivity in detecting the site of haemorrhage. An integrated angiographic and surgical approach is important in managing patients with ISIH.

Purpose: Ketamine is a commonly abused recreational drug in Southeast Asia. There are emerging reports on ketamine abuse causing liver injury and biliary dilatation. This retrospective study aims to investigate the clinical and radiological features of this condition., Methods: A retrospective search in the database of our institute was performed from January 2008 to February 2014 for patients who were ketamine abusers, with deranged liver function and/or epigastric pain, and had computed tomography of the abdomen or magnetic resonance cholangiopancreatography. Patient demographics, clinical data, and radiological findings were reviewed., Results: Twenty-six patients (11 male and 15 female) were included in this study. Eighteen (69 %) patients had fusiform dilatation of the common bile ducts (CBDs) without evidence of intrinsic or extrinsic obstruction, and non-dilated intrahepatic ducts. The degree of CBD dilatation correlated with duration of abuse. In five patients who achieved abstinence, the CBD dilatation showed improvement., Conclusions: Ketamine-related cholangiopathy manifested as fusiform dilatation of the CBD without evidence of obstructive lesions. Severity of CBD dilatation appears to be correlated with the duration of ketamine, and the condition is potentially reversible in abstinent patients.

We report a simple method to efficiently improve the detection limit of surface plasmon resonance in periodic metallic nanostructures by using small angle illumination and spectral integration analysis. The large-area gold nanoslit arrays were fabricated by thermal-annealing template-stripping method with a slit width of 60 nm and period of 500 nm. The small angle illumination induced a resonant coupling between surface plasmon mode and substrate mode. It increased ~2.24 times intensity sensitivity at 5.5° incident angle. The small-angle illumination also resulted in multiple resonant peaks. The spectral integration method integrated all changes near the resonant peaks and increased the signal to noise ratio about 5 times as compared to single-wavelength intensity analysis. Combining both small angle and spectral integration, the detection limit was increased to one order of magnitude. The improvement of the detection limit for antigen-antibody interactions was demonstrated.

Objective: The objective of our study was to evaluate the diagnostic accuracy of ultrasound in assessing musculoskeletal soft-tissue tumors superficial to the investing fascia., Materials and Methods: Seven hundred fourteen superficial soft-tissue tumors evaluated with ultrasound by two musculoskeletal radiologists were retrospectively reviewed. In all ultrasound reports, the reporting radiologists provided one, two, or three diagnoses depending on their perceived level of diagnostic certainty. Two hundred forty-seven tumors had subsequent histologic correlation, thus allowing the accuracy of the ultrasound diagnosis to be determined. Images of the lesions with a discordant ultrasound diagnosis and histologic diagnosis were reviewed, and the ultrasound features were further classified as concordant with the known histologic diagnosis, concordant with the known histologic diagnosis with atypical features present, or discordant with the known histologic diagnosis. Four hundred sixty-seven tumors without pathologic confirmation were followed up clinically., Results: Overall the accuracy of ultrasound examination for assessing superficial soft-tissue masses was 79.0% when all differential diagnoses were considered and 77.0% when only the first differential diagnosis was considered. The sensitivity and specificity of the first ultrasound diagnosis were 95.2% and 94.3%, respectively, for lipoma; 73.0% and 97.7% for vascular malformation; 80.0% and 95.4% for epidermoid cyst; and 68.8% and 95.2% for nerve sheath tumor. Reduced observer awareness of specific tumor entities tended to contribute to underdiagnosis more than poor specificity of ultrasound findings. Most tumors (236/247, 96%) were benign. The sensitivity and specificity of ultrasound for identifying malignant superficial soft-tissue tumors was 94.1% and 99.7%, respectively., Conclusion: The diagnostic accuracy of ultrasound in the assessment of superficial musculoskeletal soft-tissue tumors is high and can be improved through increased radiologist awareness of less frequently encountered tumors. Ultrasound is accurate for differentiating benign from malignant superficial soft-tissue tumors.

Ultrasonography is increasingly the first-line investigation for the assessment of soft tissue masses. With increasing experience, most soft tissues masses, particularly superficial soft tissue masses, can be specifically labeled based on their ultrasonographic appearances. This diagnosis is based on a conundrum of clinical and ultrasonographic findings rather than resting on a single sign alone. One should try to minimize labeling the ultrasonographic appearances as "nonspecific" because this adds little to what is already known. Putting a specific label on a soft tissue mass such as a lipoma, nerve sheath tumor, or giant cell tumor of tendon sheath minimizes the need for percutaneous biopsy, greatly enhances clinical efficiency with regard to discussions on management and outcome, as well as immediately reduces patient anxiety with regard to the presence of malignancy. This article addresses the general approach to ultrasonography of soft issue masses, highlighting in particular the common pitfalls encountered in their diagnosis., (Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.)

Our purpose is to compare ultrasound and fluoroscopic-guided approaches to the glenohumeral joint at the rotator cuff interval for magnetic resonance (MR) arthrography of the shoulder. Forty consecutive patients were prospectively studied. 20 patients underwent ultrasound-guided and 20 patients underwent fluoroscopic guided injection. Successful rate of ultrasound guidance is 95%. No significant difference in pain score and duration of injection between two methods (P>.05). Ultrasound-guided rotator cuff interval injection of the glenohumeral joint for MR arthrography is comparable with fluoroscopic-guided injection. Ultrasound is the preferred method as there is no ionizing radiation., (Copyright © 2013 Elsevier Inc. All rights reserved.)

Objective: To investigate the diagnostic accuracy of oblique axial intermediate weighting MR imaging in detecting partial thickness anterior cruciate ligament (ACL) bundle tears., Materials and Methods: The study protocol was approved by the institutional ethics committee. Sixty-one subjects (43 male, 18 female; mean age 27.4 years; range 9 to 57 years) with clinically suspected ACL tear or meniscal tear between September 2009 and January 2011 were studied with MRI and arthroscopy. Detection of partial tear for the ACL as a whole and for each ACL bundle by protocol A (standard orthogonal sequences) and protocol B (standard orthogonal sequences plus oblique axial intermediate weighted imaging) was compared in a blinded fashion. Performance characteristics for protocol A and protocol B were compared using sensitivity, specificity, accuracy and ROC curves. A two-tailed p value of <0.05 indicated statistical significance., Results: Fifteen (24.6%) normal, 15 (24.6%) partial and 31 complete tears were diagnosed by arthroscopy. Sensitivity, specificity and accuracy of protocol A for the diagnosis of partial tear of the ACL was 33%, 87% and 74%, while for protocol B the values were 87%, 87% and 87% respectively. The area under the curve (AUC) for the diagnosis of partial ACL tear and individual bundle tear was higher for protocol B, although this difference did not reach statistical significance (p > 0.05)., Conclusion: The addition of oblique axial imaging to standard MR imaging improves diagnostic accuracy for detecting partial tears of the ACL as well as individual bundle tears of the ACL.

Our purpose was to determine the relationship between tibiofemoral translation on magnetic resonance imaging and clinical instability of the knee following anterior cruciate ligament (ACL) injury. Within 66 patients (43 males, 23 females, mean age 30.25 years), 15 of 19 patients (80%) with an intact ACL had a demonstrable normal screw home movement, while 24 of 47 patients (51%) with an ACL tear had absence of the screw home movement. Patients with clinical instability had greater tibial translation and excursion at the lateral compartment (P=.0001). Following ACL injury, there is demonstrable absence of the normal screw-home movement with anterior tibial translation and excursion related to presence of clinical instability., (Copyright © 2013 Elsevier Inc. All rights reserved.)

Background: Angioplasty and stenting using nitinol stents is a recognized treatment option for intracranial atherosclerosis., Objective: To identify procedure-related factors that may affect patient safety and technical outcome., Methods: In this prospective study of 57 consecutive patients, the primary end points were intraprocedural technical problems, periprocedure morbidity, and complications. Major periprocedure complication was defined as all stroke or death at 30 days. Technical failure was defined as the inability to complete the procedure because of technical or safety problems. Procedure failure was defined as a procedure outcome of technical failure or major periprocedure complication. Secondary end points were procedure-related factors that may affect patient safety and technical outcome., Results: Procedure failure rate was 12.3% (7/57) (major periprocedure complication rate, 5.3% [3/57]; technical failure rate, 7% [4/57]). Initial failure in tracking of balloon or stent occurred in 20 patients, other technical problems occurred in 11 patients, including kinking or trapping of balloon catheter (2 cases), difficulty in unsheathing of stent (3 cases), forward migration of stent during deployment (4 cases), trapping of nose cone after stent deployment (1 case), fracture of delivery system (2 cases), and guidewire fracture (1 case). Unfavorable vascular morphology signified by the presence of 2 or more reverse curves along the access path was found to associate with initial failure in the tracking of instruments (OR = ∞), and occurrence of other technical problems (OR = 25)., Conclusion: Procedure-related factors could be identified and lead to improvements in patient safety and technical outcome. Tortuous vascular morphology is a key factor to be overcome.

Eleven compounds were isolated from the methanolic extract of the leaves of Solanum erianthum D. Don, including five alpha-linolenic acid analogs, alpha-linolenic acid (1), 13S-hydroxy-9(Z),11(E)-octadecadienoic acid (2), 9S-hydroxy-10(E),12(Z), 15(Z)-octadectrienoic acid (3), 9(Z),11(E)-octadecadienoic acid (4), and octadecanoic acid (5); two benzofuran-type lactones, loliolide (6) and dihydroactinidiolide (7); two steroidal alkaloids, solasonine (8) and solamargine (9); a flavonol glycoside, camelliaside C (10); and a flavone, 5-methoxy-(3,4"-dihydro-3",4"-diacetoxy)-2",2'-dimethylpyrano-(7,8:5",6")-flavone (11). Among these isolated compounds, 9 showed the most potent activity against HBsAg, with an IC50 of 1.57 microM, followed by 8 (IC50 is 5.89 microM). In the testing against HBeAg, 11 was the only active compound with an IC50 of 36.11 microM. Compound 9 also revealed strong inhibition of DNA replication towards HBV and its IC50 was 2.17 microM. However, alpha-linolenic acid (1) showed a prominent selected index (SI), both in anti-HBsAg and inhibition of DNA replication with SI values of 7.75 and 7.18, respectively. This is the first report that unsaturated fatty acid 1, steroidal alkaloid glycoside 9 and flavone 11, all showed excellent activity against HBV. These results provide lead candidates in the development of anti-HBV drugs from natural sources.

Seven new oleanane-type triterpenoids (1-7), named fatsicarpains A-G, and the known compounds 3α-hydroxyolean-11,13(18)-dien-28-oic acid (8) and 3α-hydroxyolean-11-en-28,13β-olide (9) were isolated from the leaves and twigs of Fatsia polycarpa on the basis of bioassay-guided fractionation. The structures of compounds 1-7 were elucidated through spectroscopic analyses and single-crystal X-ray crystallography of 1, 8, and 9. Cytotoxicity against HepG2 2.2.15 and AGS cells and antihepatitis B virus (HBV) and antibacterial activities of 1-9 were also evaluated in vitro.

The anterior cruciate ligament (ACL) is an important structure in maintaining the normal biomechanics of the knee and is the most commonly injured knee ligament. However, the oblique course of the ACL within the intercondylar fossa limits the visualization and assessment of the pathology of the ligament. This pictorial essay provides a comprehensive and illustrative review of the anatomy and biomechanics as well as updated information on different modalities of radiological investigation of ACL, particularly magnetic resonance imaging.

Objective: To systematically review the literature to identify the impact of polycystic ovary syndrome (PCOS) on specific health-related quality of life domains., Design: Meta-analysis., Setting: N/A., Patient(s): The outcomes of 423 patients and 285 controls from 5 articles that used the Short Form 36 (SF-36) questionnaire were used for meta-analysis., Intervention(s): N/A., Main Outcome Measure(s): The SF-36 dimensions including physical function, physical role function, body pain, general health, vitality, social function, emotional role function, and mental health were evaluated., Result(s): Compared with controls, women with PCOS had lower scores in all SF-36 dimensions: physical function (mean differences [MD], -5.46; 95% confidence intervals [CI], -8.52, -2.41), physical role function (MD, -5.76; 95% CI, -8.49, -3.03), body pain (MD, -4.55; 95% CI, -7.99, -1.11), general health (MD, -11.34; 95% CI, -19.53, -3.15), vitality (MD, -15.14; 95% CI, -17.43, -12.84), social function (MD, -15.95, 95% CI, -18.57, -13.33), emotional role function (MD, -23.86; 95% CI, -27.51, -20.21), and mental health (MD, -13.83; 95% CI, -16.13, -11.53)., Conclusion(s): The meta-analysis showed that women with PCOS score lower in each dimension of the SF-36, mostly in the emotional role function., (Copyright © 2011 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.)

Chemical investigations of the Formosan soft coral Cespitularia hypotentaculata ROXAS led to the isolation of two new verticillane diterpenoids, cespitularins R and S (1, 2), along with seven known compounds (3-9). The structures of these isolated compounds were elucidated on the basis of extensive spectroscopic analysis and by comparison with those of reported in literature. The anti-inflammatory activity using RAW 264.7 macrophages of compounds 1-9 were evaluated in vitro.

Chemical investigations of the Formosan soft coral Lemnalia flava have obtained a new ylangene-type sesquiterpenoid, (1S,2S,4R,6S,7R,8S)-4alpha-formyloxy-beta-ylangene (1), along with two known sesquiterpenoids, lemnalol (2) and isolemnalol (3). Three new nardosinane-type sesquiterpenoids, designated as paralemnolins J-L (4-6), and five known sesquiterpenoids (7-11), were isolated from the other soft coral Paralemnalia thyrsoides. The structures of metabolites 1 and 4-6 were elucidated through extensive spectroscopic analysis and chemical methods. Moreover, the anti-inflammatory activity of metabolites 1-7 and 11 was evaluated in vitro.

Abnormal fluid accumulation in tissues, including the life-threatening cerebral and pulmonary edema, is a severe consequence of bacteria infection. Chlamydia (C.) trachomatis is an obligate intracellular gram-negative human pathogen responsible for a spectrum of diseases, causing tissue fluid accumulation and edema in various organs. However, the underlying mechanism for tissue fluid secretion induced by C. trachomatis and most of other infectious pathogens is not known. Here, we report that in mice C. trachomatis infection models, the expression of cystic fibrosis transmembrane conductance regulator (CFTR), a cAMP activated chloride channel, is up regulated together with increased cytokine release and tissue fluid accumulation that can be reversed by treatment with antibiotic specific for C. trachomatis and CFTR channel blocker. However, C. trachomatis infection cannot induce tissue edema in CFTRtm1Unc mutant mice. Administration of exogenous IL-1beta to mice mimics the C. trachomatis infection-induced CFTR upregulation, enhanced CFTR channel activity and fluid accumulation, further confirming the involvement of CFTR in infection-induced tissue fluid secretion.

There is substantial heterogeneity of symptoms and signs among women with polycystic ovary syndrome (PCOS). In addition to different diagnostic criteria used, the ethnic background of women with PCOS may affect the clinical, hormonal, and metabolic characteristics of this condition. We present here studies related to the clinical, hormonal, and metabolic characteristics and response to the treatment of PCOS in Asia, which may be different from those in Western countries. It is important to take into consideration the ethnic background of patients in future studies related to PCOS.

Background: Despite the extensive use of gonadotrophin releasing hormone agonists (GnRH ag) for pituitary downregulation, the literature regarding their effect on ultrasound parameters for predicting ovarian responses are few and conflicting. The aim of this prospective study was to compare antral follicle count (AFC), ovarian volume and ovarian stromal blood flow measured by three-dimensional (3D) power Doppler ultrasound before and after pituitary downregulation., Methods: All patients received a long protocol of intranasal Buserelin from the mid-luteal phase of the cycle. In the early follicular phase of the preceding cycle before downregulation and on the second day of the treatment cycle after downregulation, patients underwent a blood test for serum FSH, LH and estradiol and a transvaginal scanning with 3D power Doppler to determine AFC, ovarian volume and ovarian 3D power Doppler flow indices., Results: Out of 104 women scanned, 85 women were analysed. Polycystic ovaries were encountered in 14 (16.5%) women. No significant differences in any of the ultrasound parameters were demonstrated before and after downregulation, in patients with normal ovaries or in those with polycystic ovaries., Conclusion: AFC, ovarian volume and ovarian 3D power Doppler flow indices did not significantly change after a short-term treatment of GnRH agonist for pituitary downregulation.

Randomized, controlled studies have shown that infliximab, the chimeric anti-tumor necrosis factor alpha (TNF-alpha) antibody, is effective for the treatment of active and fistulizing Crohn's disease. Because infliximab is beneficial in patients with Crohn's disease, in whom other therapies have failed, it has been postulated that infliximab may also be helpful in patients with ulcerative colitis. Many investigators have studied the effectiveness of infliximab in ulcerative colitis, mainly in patients who are refractory to corticosteroids. Unfortunately, these studies have not yielded a conclusive answer to the efficacy of infliximab in inducing remission in patients with severe ulcerative colitis. However, some have reported excellent results and others less effective, with the overall data being inconclusive. The purpose of this review is to summarize the current literature on the use of infliximab in ulcerative colitis, as well as to provide insight into the possible mechanisms of why it may or may not work in these difficult-to-treat patients.

Mifepristone is an orally active progesterone antagonist. It can be used for both contraceptive and non-contraceptive clinical indications. It is a very effective drug for emergency contraception with a low incidence of side effects. There is a potential for mifepristone to be used as a once-a-month pill. There is a need, however, for a simple, inexpensive and accurate method to identify the luteinizing hormone surge before this method can be used in clinical practice. The daily administration of mifepristone offers promise as an effective method of contraception but more studies need to be done. The combination of mifepristone with a prostaglandin analogue is a well-established method for termination of pregnancy of up to 9 weeks. Recent data suggest that this combination may also be used up to 9-13 weeks of pregnancy. Although mifepristone is effective in dilating the cervix before vacuum aspiration, misoprostol is probably the drug of choice in most situations. In the second trimester, mifepristone is effective in shortening the abortion process induced by prostaglandin analogues. The combination of mifepristone and prostaglandin also offers a medical method for management of miscarriages. Mifepristone has been used for a number of other indications, but further studies are needed before such treatment can be recommended.