A Chinese version of the Mini-Mental State Examination; impact of illiteracy in a Shanghai dementia survey

A dementia screening survey was carried out in Shanghai using a culturally adapted Chinese version of the Mini-Mental State Examination. A probability sample of 5055 community-dwelling elderly in Shanghai was surveyed, 1497 aged 55-64, 2187 aged 65-74, and 1371 aged 75 and over. In the 73.3% of the subjects who had gone to school, using the age and education adjustments suggested by Kittner et al. (1986), [Kittner et al. J Chron Dis 39: 163-170; 1986] suitable cutoff scores could readily be selected to identify the subjects who should be examined intensively for the presence of dementia. However, in the 26.7% who had not gone to school, there was a significant increase in low scores on the mental status test as well as a different error pattern, reflecting the lack of formal education. Methods for following cognitive changes in illiterate individuals need further development.

The uptake and intracellular distribution of [35S]trithiomolybdate in bovine liver in vivo

[35S] trithiomolybdate was administered intravenously to a group of four steer at two dose rates, 1 and 26 mg Mo per animal. Radioactivity appeared rapidly in the liver and was distributed in all the subcellular fractions examined. Examination by Sephadex G-100 gel-filtration of the cytosol fraction showed that distinct 35S-binding protein peaks were present. The protein-bound radioactivity was displaceable and was identified as [35S]thiomolybdates. No radioactivity eluted with metallothionein, but 35S was associated with the high molecular weight copper fraction, eluted in the void volume of the column, which increased transiently after the administration of the higher dose. It was suggested that the presence of protein-bound thiomolybdates in the liver gave rise to new ligands, which altered the equilibrium of copper between the different metal-binding proteins. This might be similar to the alteration in the copper-binding of albumin produced by the presence of thiomolybdates.

[Evaluation of CT scan for carcinoma of the gastric cardia]

CT scans of 50 cases with carcinoma of gastric cardia were analyzed. 45 cases were operated but 12 were explored only. The causes of unresectability were: bulky primary tumor, regional lymph node involvement, infiltration of the adjacent structures, e.g. liver, pancreas, spleen and diaphragm, intragastric extension and ascites. By CT scan, the detection rate of the visceral organ involvement was: diaphragm 4/7, pancreas 3/10, liver 4/6 and spleen 5/6. Therefore, it is very important to have a preoperative CT scan for carcinoma of gastric cardia.

[Combination of radiation, chemotherapy and surgery in rectal cancer--an analysis of 128 patients]

The results of 128 patients with rectal cancer treated by the combination of surgery, preoperative radiotherapy and chemotherapy from June 1975 to December 1979 are reported and compared with those by operation alone. The 5 year survival rates of the different groups were: 69.5% (16/23) for radical surgery plus preoperative radiotherapy and chemotherapy (RRCG), 56% (14/25) for radical surgery plus preoperative radiotherapy, 53.8% (7/13) for radical surgery plus chemotherapy and 40% (10/25) for radical surgery alone. The 5 year survival rate of RRCG was significantly higher than that of the radical surgery alone group (P less than 0.05). The authors believe that the combination of preoperative radiotherapy, chemotherapy plus radical surgery improves the 5 year survival rate and is worthy of further study.

[Preoperative chemotherapy of esophageal cancer]

A series of 25 patients with advanced esophageal cancer treated from Mar. 1981 to Sep. 1982 by preoperative chemotherapy plus surgery is reported. All the patients came from the hospitals of the cooperative research group and were randomized into chemotherapy and control groups. They were proved by X-ray, cytology and histopathology prior to treatment. By histology, 22 cases were squamous cell carcinoma, 1 adenocarcinoma and 2 squamous adenocarcinoma. The COF chemotherapy consisted of Vincristine 1 mg, cyclophosphamide 600 mg and 5-fluorouracil 500 mg IV on days 1 and 8 with or without the addition of Pingyangmycin, a drug equivalent to Bleomycin A5, at the dose of 10 mg IM on days 1, 3, 6 and 8. The interval between the ending of chemotherapy and the surgical resection was 5-6 days. The results showed that preoperative chemotherapy caused no myelosuppression, but merely mild gastrointestinal symptoms. All patients were operated and resected without difficulty. The subjective improvement in various degrees and the shrinkage of tumor in the X-ray films were present in 5/25 cases who received preoperative chemotherapy. The histopathological changes in the chemotherapy and control groups (16 specimens) were different. In the chemotherapy group, excessive keratinization in the squamous component of the esophageal cancerous tissue appeared in the resected specimens. The incidence of degeneration and necrosis in the squamous epithelium adjacent to carcinoma was higher in the chemotherapy group (P less than 0.01). The results suggested that such combined modality is worth further study.

Development of a radioimmunoassay for prostaglandin D2 using an antiserum against 11-methoxime prostaglandin D2

A sensitive and specific radioimmunoassay for prostaglandin D2 has been developed using its stabilized 11-methoxime derivative, which was obtained after treatment of prostaglandin D2 with methoxamine-HCl. The antiserum was obtained after injection of prostaglandin D2-methoxamine coupled to bovine serum albumin. A (125I)-Histamide prostaglandin D2-methoxamine tracer was prepared by iodination of the corresponding histamide, followed by thin layer chromatography purification. The sensitivity of the assay was 280 femtomoles per ml at 50% displacement. The cross reactivities were 15% with prostaglandin D1-methoxamine and less than 0.20% with other prostaglandins. Determination of the half-life of prostaglandin D2 in a solution containing albumin was also carried out, since it has been shown to catalyze prostaglandin D2 destruction. The unstability of this prostaglandin is due to the presence of a beta-hydroxy ketone group, and all prostaglandins possessing this labile moiety could be stabilized by such a derivatization before developing a radioimmunoassay.

Disposition in rats of a polyoxypropylene-polyoxyethylene copolymer used in plasma fractionation

A polyoxypropylene-polyoxyethylene block copolymer of about 4750 daltons (Poloxamer 108, Pluronic F-38) used in a new protein fractionation procedure may be infused into patients receiving therapeutic plasma fractions. We studied the disposition and pharmacokinetics of Poloxamer 108 in rats as an initial step towards understanding its behavior in man. After iv administration in rats, about 94% of 7 or 100 mg/kg doses of ethylene-14C-labeled polymer was excreted in the urine in 3 days. About 6% of the label appeared in feces. Erythrocyte membranes were not permeable to the polymer, and only the parent compound was demonstrable in urine. Twenty hours after dosing, small residues were detectable only in the kidney, liver, small intestine, and carcass. The third phase of the plasma disappearance pattern was evident only at the larger dose, but plasma disappearance kinetics were independent of the dose in the range used here. Thus, most of poloxamer 108 was eliminated rapidly in rats by renal excretion, and a smaller portion probably was removed by biliary excretion. These results will be applied to continuing studies of Poloxamer 108 disposition in man.