Altered gene and protein expression of glucose transporter1 underlies dexamethasone inhibition of insulin-stimulated glucose uptake in chicken muscles

A study was performed to characterize the effects of dexamethasone (DEX) and insulin administration on gene expression of glucose transporters (GLUT) in chicken (Gallus gallus domesticus) skeletal muscles and in cultured embryonic myoblasts. Three groups of 1-wk-old male chickens were randomly subjected to one of the following treatments for 7 d: DEX (a subcutaneous injection of 1 mg/kg BW, twice daily at 0800 h and 2000 h), controls (injected with saline), and pair-fed controls (restricted to the same feed intake as for the DEX treatment). Expressions of GLUT-1, GLUT-3, GLUT-8, and 18S rRNA mRNA were determined by quantitative reverse transcription PCR in the pectoralis major (PM) and biceps femoris (BF) muscles. Using chicken embryonic myoblasts (CEM), the interaction between DEX (200 nM) and insulin (100 nM) administration was evaluated on GLUT gene and GLUT-1 protein expressions and 2-deoxy-D-[1, 2-(3)H]-glucose (2-DG) uptake. Myoblasts were incubated with serum-free medium for 3 h in the presence or absence of insulin (0, 0.02, 0.1, 0.5, and 2.5 μM). Although GLUT-1 is not considered an insulin-responsive GLUT in mammals, this study shows that insulin stimulated 2-DG uptake and GLUT-1 mRNA and protein expression in CEM (P < 0.0001), suggesting that both are regulated in chicken skeletal muscle. Dexamethasone inhibited insulin-stimulated glucose uptake in CEM (P < 0.0001), likely accounting for insulin resistance in skeletal muscles. The results of the present study indicate that the altered GLUT-1 gene and protein expression may contribute to the insulin resistance induced by DEX treatment in chicken muscles.

Effect of dietary supplemental nicotinic acid on growth performance, carcass characteristics and meat quality in three genotypes of chicken

The effects of dietary supplemental nicotinic acid (NA) on growth performance, carcass characteristics and meat quality were investigated in three genotypes of chicken. Fast-growing AA (Arbor Acres) broilers were compared with two genotypes of a slow-growing local breed, Beijing-You, that had undergone selection for and against intramuscular fat content respectively (BJY+IMF and BJY-IMF). The treatments were arranged 3×4 factorial completely randomized design. Day-old females (n=624) were allocated to four treatments with six replicates per treatment and fed diets (basal contained ~25 mg NA/kg) supplemented with 0, 30, 60 and 120 mg NA/kg. A sample of 72 birds from each genotype was slaughtered at market time (8 weeks of age for AA and 16 weeks of age for BJY). The breast muscles of AA broilers were darker, had less redness and yellowness, lower drip loss and higher shear force as compared to the BJY genotypes (p<0.01). The highest drip loss and the lowest shear force among the three genotypes were apparent in BJY+IMF (p<0.01). Increasing supplementation from 0 to 60 mg NA/kg tended to increase average daily gain (ADG), average daily feed intake, width of intermuscular fat band, thickness of subcutaneous fat (including skin) and percentage of abdominal fat but, for most variables, values decreased slightly with 120 mg NA/kg. Increasing supplementation to 60 mg NA/kg decreased (quadratic, p<0.001) drip loss, but it increased at 120 mg NA/kg. The present results indicate that (i) the AA broilers fed corn-soybean meal based-diets require approximately 60 mg NA/kg to maximize ADG and meat product yield and decrease the drip loss of breast muscle; (ii) the addition of 30 mg NA/kg meets the requirement of BJY genotypes; and (iii) there seems to be no beneficial effect of NA supplementation on chicken meat quality except for limiting the drip loss.

Effects of dietary vitamin E on immunological stress of layers and their offspring

In the present study, two experiments were conducted to evaluate the effect of vitamin E (VE) supplementation of a commercial layer diet on the laying performance and immunological stress responses of hens and their offspring. In experiment 1, responses to increased dietary VE levels were evaluated on 180 White Leghorn layers between 20 and 35 weeks of age. There were three levels of VE in the diets (0, 40 and 100 IU/kg) and five replicates per treatment, each containing 12 hens. Results showed that the high level of VE supplementation (100 IU/kg) had a beneficial effect on feed intake and feed efficiency of hens (p < 0.05), compared with the VE-deficient or low-level group. In experiment 2, 540 female progeny from the VE-treated hens in experiment 1 were used. The experimental design consisted of three levels of VE supplementation (the same as their mothers') × 3 vaccinating routines, the first vaccination being administered on day 5, 8 or 11. All vaccines and the subsequent vaccinating intervals were identical. In the interim of the experiment, each bird was injected celiacly with Escherichia coli lipopolysaccharide (LPS). The results showed that antibody titres against Newcastle disease virus (NDV) or avian influenza virus (AIV) and the plasma concentration of interleukin (IL)-1 were increased by the high level of VE supplementation. There were significant effects of the day of initial immunization with infection bursal disease on the NDV and AIV antibody titre, H/L ratio and plasma concentration of corticosterone and IL-1 before and after injecting LPS, suggesting the occurrence of immunological stress. There was also significant interaction between VE and vaccination routine on the immune functions of experimental birds. Considered together with the results of experiment 1, VEs biological function appeared to be dose-dependent, especially with regard to its positive effect on the immune responses of young chickens.

Live performance, carcass composition, and blood metabolite responses to dietary nutrient density in two distinct broiler breeds of male chickens

A study was conducted to evaluate the effects of varying nutrient density with constant ME:CP ratio on growing performance, carcass characteristics, and blood responses in 2 distinct broiler breeds of male chickens (Arbor Acres, a commercial line, and Beijing-You, a Chinese nonimproved line). Experimental diets were formulated with high, medium, or low nutrient densities for 3 growing phases. Starter diets (1 to 21 d) contained 23, 21, and 19% CP with 3,059, 2,793, and 2,527 kcal/kg of ME; grower diets (22 to 35 d) contained 21, 19, and 17% CP with 3,150, 2,850, and 2,550 kcal/kg of ME; and finisher diets (36 to 42 d for Arbor Acres and 36 to 91 d for Beijing-You) had 19, 17, and 15% CP with 3,230, 2,890, and 2,550 kcal/kg of ME. Male hatchlings (216 of each breed) were randomly assigned to 6 replicates of 12 birds in each treatment. Arbor Acres broilers had better (P < 0.001) BW gain, feed conversion ratio (FCR), and carcass yield, but had greater (P < 0.001) abdominal and carcass fat deposition. In both breeds, the higher nutrient density increased (P < 0.05) BW gain, protein efficiency ratio, and energy efficiency ratio while decreasing (P < 0.05) feed intake and FCR. The breed differences were increased for FCR, protein efficiency ratio, and energy efficiency ratio in the starter period and decreased for carcass chemical composition, respectively, by higher nutrient density. These findings indicate that 1) genetic improvement has a significant effect on broiler responses to dietary nutrient density, 2) performance differences between breeds are lessened with diets of low nutrient density, 3) carcass quality differences are less when birds were fed diets of high nutrient density, 4) carcass composition is hardly modified by nutrient density and both breeds exhibit similar metabolite responses to dietary concentrations, and 5) optimal diets are deduced for these breeds for the 3 growing phases.

Effects of L-arginine supplementation on glucose and nitric oxide (NO) levels and activity of NO synthase in corticosterone-challenged broiler chickens (Gallus gallus)

In the present study, three experiments were conducted to investigate the effect of oral supplementation of l-arginine (ARG) on the disposal of glucose in stressed-broiler chickens (Gallus gallus domesticus). In all the three experiments, the broiler chickens were randomly subjected to one of the four treatments at the beginning of the experiments: oral administration of saline, glucose (2.0g/kg body weight, BW), l-arginine (0.5g/kg BW) or mixed solution (2.0g glucose+0.5g arginine/kg BW). Immediately after the oral treatment, the experimental chickens were subcutaneously injected with corn oil (Experiment 1), corticosterone (CORT, 4mg/kg BW, Experiment 2) or insulin (1U/kg BW, Experiment 3), respectively. Blood samples were obtained at the beginning (0-h), 0.5-, 1- and 2-h time points after injection and the levels of plasma glucose, urate, nitric oxide (NO) and activity of NO synthase (NOS) were measured. The results showed that plasma NO levels and NOS activity were significantly suppressed while glucose and insulin concentrations were increased by CORT treatment. In contrast, insulin administration improved the circulating level of NO and activity of NOS. ARG supplementation could not improve the circulating levels of NO and NOS activity in CORT-challenged chickens and, in turn, the glucose disposal. The result suggests that NO is involved in insulin-mediated glucose transport in chickens, as well as that in mammals. The reduced circulating level of NO resulted from the suppressed activity of NOS rather than the reduced substrate concentration.

Corticosterone suppresses insulin- and NO-stimulated muscle glucose uptake in broiler chickens (Gallus gallus domesticus)

We evaluated the effects of stress as mimicked by corticosterone (CORT) administration on the uptake of glucose by skeletal muscles (M. fibularis longus) in broiler chickens (Gallus gallus domesticus). The results showed that both chronic (7 d) and short-term (3 h) CORT administration resulted in hyperglycemia and hyperinsulinemia. Plasma level of nitric oxide (NO) and the activity of NO synthase (NOS) were both suppressed by either chronic or acute stress. In vivo CORT treatment could stimulate the in vitro uptake of 2-deoxy-D-[1,2-3H]-glucose (2-DG). Sodium nitroprusside (SNP) administration improved the in vitro uptake of 2-DG in both CORT and control groups. In CORT treatment, however, the stimulating effect of NO on 2-DG uptake was relatively lower compared to control group, whereas it was restored by insulin. Insulin stimulated muscle in vitro 2-DG uptake in either control or CORT group, with the improvement being significantly higher in control chickens. The results indicated that the reduced circulating and muscle level of NO level via the suppression of NOS by corticosterone treatment was involved in the stress-induced insulin resistance. It appears that CORT could suppress the insulin stimulated glucose uptake in skeletal muscle, inducing insulin resistance in broiler chickens. We conclude that NO could stimulate glucose transport in chicken skeletal muscle and that the reduced circulating and muscle level of NO is involved in the insulin resistance induced by corticosterone treatment.

Orientobilharzia species: neglected parasitic zoonotic agents

Parasites of the genus Orientobilharzia belong to Platyhelminthes, Trematoda, Digenea, Schistosomatidae, and the type species is Orientobilharzia turkestanicum. O. turkestanicum was first described by Skrjabin from cattle in Russian Turkestan in 1913. Adult worms of Orientobilharzia species live in the portal veins or intestinal veins of cattle, sheep and other mammals, and often cause orientobilharziasis in China, India, Mongolia, Pakistan, Iraq, Iran in Asia, and Russia and Turkey in Europe. More importantly, the cercariae of Orientobilharzia species can infect humans and often cause cercarial dermatitis. Though Orientobilharzia species have been confirmed as zoonotic agents, they have been largely neglected, compared with other pathogens causing cercarial dermatitis, such as Trichobilharzia spp., Schistosoma spindale and Bilharziella sp., which have attracted considerable attention. Here we review the current status of knowledge on the taxonomy of Orientobilharzia spp., human and animal infections with Orientobilharzia spp., and address some considerations for further work on the systematics and pathogenesis of these organisms.

Corticosterone administration and dietary glucose supplementation enhance fat accumulation in broiler chickens

1. The effects of exogenous corticosterone administration and glucose supplementation on energy intake, lipid metabolism and fat deposition of broiler chickens were investigated. 2. A total of 144 three-d-old male chickens were randomly assigned to one of the following 4 treatments for 7 d: a low energy diet (10.9 MJ ME/kg, 200 g/kg CP) with or without corticosterone (30 mg/kg diet) and drinking water supplemented with glucose (80 g/l) or saccharine (2 g/l, control). 3. Body weight (BW) gain and breast and thigh muscle yields (% body mass) were all significantly decreased by corticosterone treatment. The relative cumulative feed intake (RCFI) and relative ME intake (RMEI), rather than the feed (FI) or ME intake (MEI) were increased by corticosterone administration. Both feed efficiency (FE) and caloric efficiency (CE) were decreased by corticosterone administration. Corticosterone administration had no obvious effect on water consumption. 4. Glucose supplementation had no influence on BW gain and breast and thigh muscle yield (as % of body mass). FI or RCFI was decreased while MEI or RMEI was increased by glucose supplementation. FE was improved by glucose treatment, whereas CE was reduced. 5. Liver weight and abdominal, cervical and thigh fat deposits were all significantly increased by either corticosterone or glucose treatment. 6. Plasma concentrations of glucose, urate, triglyceride, non-esterified fatty acids (NEFA), very low density lipoprotein and insulin were all significantly increased by corticosterone treatment. Glucose supplementation had no obvious influence on any of the measured plasma parameters except for NEFA, which were significantly increased. 7. Lipoprotein lipase activities in either cervical or abdominal adipose tissues, rather than in thigh fat tissue, were significantly elevated by either glucose or corticosterone treatment.

Functionalization of nylon membranes via surface-initiated atom-transfer radical polymerization

The ability to manipulate and control the surface properties of nylons is of crucial importance to their widespread applications. In this work, surface-initiated atom-transfer radical polymerization (ATRP) is employed to tailor the functionality of the nylon membrane and pore surfaces in a well-controlled manner. A simple two-step method, involving the activation of surface amide groups with formaldehyde and the reaction of the resulting N-methylol polyamide with 2-bromoisobutyryl bromide, was first developed for the covalent immobilization of ATRP initiators on the nylon membrane and its pore surfaces. Functional polymer brushes of 2-hydroxyethyl methacrylate (HEMA) and poly(ethylene glycol)monomethacrylate (PEGMA) were prepared via surface-initiated ATRP from the nylon membranes. A kinetics study revealed that the chain growth from the membranes was consistent with a "controlled" process. The dormant chain ends of the grafted HEMA polymer (P(HEMA)) and PEGMA polymer (P(PEGMA)) on the nylon membranes could be reactivated for the consecutive surface-initiated ATRP to produce the corresponding nylon membranes functionalized by P(HEMA)-b-P(PEGMA) and P(PEGMA)-b-P(HEMA) diblock copolymer brushes. In addition, membranes with grafted P(HEMA) and P(PEGMA) brushes exhibited good resistance to protein adsorption and fouling under continuous-flow conditions.

Effects of Diet and Stress Mimicked by Corticosterone Administration on Early Postmortem Muscle Metabolism of Broiler Chickens

Three experiments were conducted to evaluate the effects of preslaughter physiological states mimicked by long- or short-term administration of corticosterone (CORT) and dietary energy sources on muscle glycogen contents and meat quality of broiler chickens. In experiment 1, the broilers were fed a high lipid diet (LD) or a normal diet (ND) that differed in carbohydrate (3.8%) and lipid (2.5%) contents from 21 d of age. From 28 d of age onwards, 50% of the chickens in each dietary treatment were subjected to CORT treatment (30 mg/kg of diet). At 7 and 11 d after CORT supplementation, musculus pectoralis major was sampled before and immediately after slaughter and analyzed for glycogen, pH, and R-value. In experiment 2, broilers, fed with the LD or ND diet from 21 d of age were subjected to 1 single s.c. injection of CORT (4 mg/kg of BW) for 3 h to mimicked acute stress at 46 d of age. In experiment 3, broiler chickens were supplied with water supplemented with glucose (30 g/L) for 1 wk before slaughter and were then subjected to the same CORT treatment as experiment 2. Blood and muscle samples were respectively obtained before and immediately after slaughter and analyzed for plasma glucose, urate and lactic acid, and muscle variables. Plasma concentrations of glucose and urate were significantly increased by acute CORT administration, whereas the lactic acid was not changed. Neither dietary energy source nor water glucose supplementation had any influence on the plasma variables. Dietary energy source or water glucose supplementation could not alter glycogen stores in musculus pectoralis major. Breast muscle glycogen stores were increased by stress mimicked by long-term CORT administration rather than by acute treatment. Preslaughter stress reactions had no relation to the depletion of breast muscle glycogen during the initial postmortem period. The initial breast muscle pH was significantly decreased by long-term CORT administration. The result suggests that short-term upregulation of circulating CORT is not involved in the elevated drip loss induced by preslaughter stress.

Altered development and protein metabolism in skeletal muscles of broiler chickens (Gallus gallus domesticus) by corticosterone

Two trials were conducted to investigate the effect of corticosterone (CORT) on protein metabolism and the amino acid composition in muscle tissues of broiler chickens (Gallus gallus domesticus). In Trial 1, two groups of 30 broiler chickens were subjected to control or CORT treatment (30 mg/kg diet) from 28 to 39 days of age. In Trial 2, three groups of chickens of 28 days of age were randomly subjected to one of the following treatments for 7 days: CORT (30 mg/kg diet), pair-fed (maintaining the same feed intake as CORT treatment) and control treatments. The body mass gain and feed efficiency was significantly decreased by CORT treatment, while the food intake was decreased. The breast and thigh masses (% body mass) were significantly suppressed by CORT treatment, while the abdominal fat and liver masses (%) were obviously increased. The plasma levels of glucose, urate and total amino acid were significantly elevated by CORT treatment. The capacity for protein synthesis, estimated by RNA:protein ratio, were significantly suppressed by CORT in M. pectoralis major and M. biceps femoris. The 3-methylhistidine concentrations were significantly increased in both M. pectoralis major and M. biceps femoris of CORT chickens, compared to control but not the pair-fed chickens. The amino acid composition of M. pectoralis major and M. biceps femoris was not significantly affected by CORT treatment. In conclusion, the arrested growth in skeletal muscles induced by CORT administration has tissue specificity. The CORT treatment retards the growth of skeletal muscle by suppressed protein synthesis and augmented protein catabolism.

Survey of helminths in adult sheep in Heilongjiang Province, People's Republic of China

The prevalence of helminths in adult sheep was investigated in Heilongjiang Province, People's Republic of China between January 1999 and September 2003. A total of 326 adult sheep representing local breeds (Xingjiang Fine Wool Sheep, Dongbei Fine Wool Sheep) as well as introduced breeds (Merino and Charollais) from representative geographical locations in Heilongjiang Province were slaughtered and examined for the presence of helminths. The worms were examined, counted and identified to species according to existing keys and descriptions. A total of 26 helminth species were found representing 2 phyla, 3 classes, 13 families and 20 genera. All sheep were infected by more than one helminth species. Oesophagostomum columbianum, Haemonchus contortus and Trichostrongylus colubriformis were the most common nematode species, and Paramphistomum cervi, Orientobilharzia turkestanica and Fasciola hepatica were the most common trematode species, whereas the infection of adult sheep with cestodes was uncommon. The results of the present investigation provide relevant "base-line" data for Heilongjiang Province, China, for assessing the effectiveness of future control strategies against helminth infections in sheep.

Prevalence of helminthes in adult dogs in Heilongjiang Province, the People’s Republic of China

The prevalence of helminthes in adult dogs was investigated in Heilongjiang Province, the People's Republic of China, between 1996 and 2004. A total of 178 adult farm dogs from representative geographical locations in Heilongjiang Province were killed and examined for the presence of helminthes using a helminthological approach. The worms were examined, counted, and identified to species according to existing keys and descriptions. A total of 17 species of helminthes were found to infect dogs, and they represented two phyla, three orders, 13 families, and 15 genera. All dogs were infected by more than one helminth species. Clonorchis sinensis (26.4%), Paragonimus westermani (7.9%), and Metagonimus yokogawai (6.2%) were the most common trematode species; Mesocestoides lineatus (20.2%), Taenia hydatigena (19.7%), and Dipylidium caninum (14.6%) were the most common cestodes species; and Ancylostoma caninum (66.3%), Toxocara canis (36.5%), and Trichinella nativa (21.9%) were the most common nematode species. The results of the present investigation provide relevant "base-line" data for assessing the effectiveness of future control strategies against helminth infection in dogs in Heilongjiang Province, China.

The first tetrathiafulvalene- sigma-polynitrofluorene diads: low HOMO-LUMO gap, amphoteric redox behavior, and charge transfer properties

[structure: see text] The synthesis, solution redox behavior, EPR, and intramolecular charge transfer properties of novel donor-acceptor diads of TTF-sigma-A type (TTF = substituted tetrathiafulvalene, sigma = saturated spacer, A = polynitrofluorene acceptor) are reported. The HOMO-LUMO gap for compound 6 is as small as 0.3 eV, and spectroelectrochemical experiments reveal its electrochromic behavior in the near-IR region.

Abnormal ACTH and prolactin responses to fenfluramine in rats exposed to single and multiple doses of MDMA

The present study examined the persistent functional consequences associated with exposure to single and multiple doses of (+/-) 3,4-methylenedioxymethamphetamine (MDMA) as reflected by the neuroendocrine responses to d,l-fenfluramine (FEN). Adult male rats were administered a single dose of MDMA (20 mg/kg, s.c.) and challenged 2 weeks later with saline or FEN (2, 4, 6 and 8 mg/kg, s.c.). The corticotropin (ACTH) response to FEN (6 and 8 mg/kg) was blunted and the prolactin response to FEN (4 and 6 mg/kg) was enhanced in MDMA pre-treated rats. The ACTH and prolactin responses to FEN (6 mg/kg, s.c.) were then evaluated 4, 8 and 12 months after exposure to single and multiple doses MDMA (20 mg/kg, s.c. and 20 mg/kg, s.c., bid, x 4 days, respectively). The ACTH response to FEN was significantly reduced at 4 and 8 months in both MDMA treatment groups, and at 12 months in the multiple dose group only. In contrast, the prolactin response to FEN was enhanced in both groups of MDMA treated rats at 4 months, but only in the multiple dose group at 8 months. By 12 months, the prolactin response to FEN had normalized. Following multiple doses of MDMA, 5-HT concentrations were reduced significantly in the frontal cortex at 4 and 12 months. The results indicate that exposure to single or multiple doses of MDMA can produce functional alterations which can persist for months, whereas the biochemical sequelae were less robust and shorter lived.

Clinical measurement of antibodies against acetylcholine receptor (AchR), SOD and LPO in patients with myasthenia gravis (MG) before and after thymectomy

The antibodies against acetylcholine receptor AchR and levels of SOD and LPO were measured in 11 patients with myasthenia gravis (MG), and the results were compared with normal controls and patients with diseases other than MG. The results showed that the antibodies against AchR were higher as compared with other groups before and after operation. The post-operative level of antibodies was obviously lower than the pre-operative value. An slight increase in SOD and significant decrease in mean value of LPO after surgery were noted. The possible mechanism was discussed.

[The impact of diltiazem on aminophylline serum concentration--a clinical study]

Aminophylline was used in 64 hospitalized patients with asthma and the change of aminophylline serum concentration and clinical manifestations were observed before and after the addition of diltiazem. The results suggested that mean aminophylline serum concentration increased 0.2 percent (P > 0.05), FEV1 increased 9.2 percent (P < 0.01), PO2 increased 5.3 percent (P < 0.01), PCO2 decreased 7.1 percent (P < 0.01), after the addition of diltiazem. These data indicated that the addition of diltiazem did not change aminophylline serum concentration but ameliorate clinical manifestations. However, after the addition of diltiazem, due attention should be paid to the change of blood pressure.

Comparative study of diagnostic systems: Chinese Classification of Mental Disorders-Second Edition versus DSM-III-R

We report on the diagnostic comparative study of the Chinese Classification of Mental Disorders-Second Edition (CCMD-2) and the DSM-III-R in a field trial in China. The Adult Diagnostic Interview Schedule-Second Edition (ADIS-2), a modified diagnostic interview schedule that can generate both CCMD-2 and DSM-III-R diagnoses, was used to test 254 psychiatric patients in China. It was found that the reliability and validity of the CCMD-2 and DSM-III-R are compatible in most diagnostic categories such as schizophrenia, delusional disorder, bipolar disorders, and depressive disorders. The discrepancies between Chinese and American diagnostic systems were found mainly in neurasthenia and hysterical neuroses. Such discrepancies may have resulted from frequent changes of the diagnostic terms in the West, such as the phenomenon of neurasthenia, or from creating a new disorder entity in CCMD-2, such as "Eastern gymnastic exercises-induced mental disorder. "Further cross-cultural studies focusing on these discrepant disorders are urgently needed to understand the cultural influences on diagnosis, as well as to improve the professional classification of mental disorders in different diagnostic systems.

Rupture of thoracic aortic aneurysm into the lung with formation of pseudoaneurysm: diagnosis and treatment

Three patients with rupture of thoracic aortic aneurysm into the lung with formation of pseudoaneurysm were admitted to our hospital in 1991, of whom, 2 had ascending aortic aneurysms which ruptured into the right upper pulmonary lobe, and another one had descending aortic aneurysm rupturing into the left upper lobe. All 3 cases were misdiagnosed as having pulmonary carcinoma or mediastinal tumor by the other hospital as well as by us. Correct diagnosis was made by aortography or at exploratory thoracotomy. Our preliminary experiences in the diagnosis and treatment of the disease are presented in this paper.