Analysis of microvascular network in bulbar conjunctiva by image processing

A digital image processing procedure has been developed for obtaining quantitative morphometric data on the microcirculatory network in the human bulbar conjunctiva. Highlights of this semi-automated approach include: 1. extraction of morphometric information that cannot be readily obtained by manual methods--length, diameter, and diffusion distributions; 2. speed and consistency in data generation--only 10 minutes are required to scan and to analyze 6.7 mm2 of conjunctiva microvasculature. The variation was less than 5% when images of the same area in the same eye were subjected to analysis at different times; 3. avoid the human bias factor--the data obtained by repeated analysis of the same negative varied by less than 0.02%.

Hepatocellular carcinoma associated with second primary malignancy

In a consecutive series of 562 patients with pathologically documented hepatocellular carcinoma (HCC), 12 patients (2.1%) were found to have a second primary malignancy elsewhere. Of these, eight were male, four female, with ages ranging from 49 to 76 years (mean 60.7 +/- 9.3 years). The associated cancers included eight cases of gastric cancers, an esophageal cancer, a stump cancer, a case of myelocytic leukemia and a histiocytic lymphoma. Eight cases had both malignancies diagnosed at the same admission. In the other four, HCC were detected after an interval of 4, 10, 12 and 39 months. Two had received previous chemotherapy or radiotherapy. Fifty percent of the 12 patients were hepatitis B surface antigen (HBsAg) positive. Their liver function tests and alpha-fetoprotein levels were consistent with those of patients with HCC alone. The results suggest that the occurrence of HCC concomitant with or arising after another primary malignancy in Taiwan is not rare.

Microvascular tone in a skeletal muscle of spontaneously hypertensive rats

We studied the degree of arteriolar smooth muscle constriction in the spinotrapezius muscle microcirculation of spontaneously hypertensive rats and their normotensive controls, Wistar-Kyoto rats. The constriction was expressed in the form of a nondimensional tone as the difference between steady state and dilated diameter (after papaverine treatment) divided by the dilated diameter. Both animal strains showed on average a progressive increase of tone toward the more distal arterioles, with a peak tone being reached in the transverse arterioles. Tone values in the hypertensive animals were consistently elevated. The number of arterioles that had more than 5% tone (so-called responder arterioles) was higher in the hypertensive animals. These studies suggest that, besides the anatomical adjustments documented earlier in our laboratory in the arteriolar network of this muscle, functional adjustments in the form of an elevated microvascular tone are associated with the elevated resistance in spontaneously hypertensive rats.

Developing primary health care for a nomad tribe: the Penans of the Baram

Unlike much of Peninsular Malaysia, the Baram District of Sarawak remains sparsely populated and underserved, one of the most underserved peoples being the nomadic and semi-nomadic Penans of the Baram. Until quite recently these Penans lived as small nomadic bands of hunter-gatherers. More recently, they have begun to settle in longhouses. However, lacking the necessary skills to live a settled mode of life, these Penans suffer a great deal of hunger, malnutrition, disease and death. Primary health care with its emphasis on the seven essential elements, including food production and nutrition, environmental sanitation, good maternal and child health, knowledge of disease and how it can be prevented as well as the treatment and control of locally endemic diseases, is of critical value in the survival of the semi-nomadic Penans. The specially designed primary health care programme for the Penans of the Baram is outlined briefly in this paper.

Psychosocial factors and the health of the elderly Malaysian

Consequent to rapidly declining mortality and birth rates, developing countries, including Malaysia, can expect a rapid increase in the population aged 60 years and above. The health of the elderly is intimately tied up with both biophysical as well as psychosocial factors which include status loss, loneliness, fear of illness and death, poverty, harmful life-styles and deterioration of the quality of life. The effects of these psychosocial factors can manifest as sleep difficulties, worry and anxiety, depression, loss of interest, and a feeling of tiredness. In extreme cases, there may be auditory or visual hallucinations or paranoia. In the present paper, which is based upon a WHO sponsored study of 1001 elderly Malaysians, it is noted that 36% of the elderly have sleep difficulties, 47% "feel tired", 31% have a "loss of interest" and 22% are "worried tense". However 71% of the elderly are able to correctly perform at least 12 of 15 cognitive tests. 20% of elderly men smoke 15 or more cigarettes a day while 44% smoke at least one cigarette a day. 40% of elderly men indicate that their families complain about the amount of alcohol they drink. Undoubtedly primary health care programmes need to be re-oriented to the problems and needs of the elderly in countries such as Malaysia.

Hemostatic effect of endoscopic local injection with hypertonic saline-epinephrine solution and pure ethanol for digestive tract bleeding

An uncontrolled study for the assessment of the hemostatic effects of endoscopically injected hypertonic saline-epinephrine (HS-E) solution and pure ethanol (PE) was carried out in 67 patients with nonvariceal gastrointestinal bleeding. The HS-E group included duodenal ulcer (18), gastric ulcer (9), gastric cancer (2), polyp (2), marginal ulcer (1), and esophageal cancer (1). Bleeding was active in 15 (pulsating, 3; oozing, 12). The hemostatic effect was permanent in 29 cases (87.9%) but failed in four cases (12.1%). The PE group consisted of 34 patients with duodenal ulcer (25), gastric ulcer (4), polyp (2), marginal ulcer (2), and gastric cancer (1). There was active bleeding in 14 (pulsating, 3; oozing, 11). The hemostatic effect was permanent in 31 cases (91.2%), temporary in 1 case (2.9%), and failed in 2 cases (5.9%). We conclude that endoscopic local injection with HS-E or PE is a simple maneuver with reasonable cost, high safety, and satisfactory hemostatic efficacy in the treatment of nonvariceal gastrointestinal bleeding.

The development of culture-specific health education packages to increase case-finding of leprosy in Sarawak

For any health education to succeed, the people's perception of the disease, their beliefs and cultural practices are of utmost importance as these have tremendous influence on their acceptance of new ideas. It is therefore essential to develop appropriate health education packages based on the understanding of the traditional and socio-cultural belief systems of the people. Thus on the basis of anthropological studies, health education packages were developed for the leprosy control programme in Sarawak, aimed at both adults and children. Newspaper articles, cartoon tape-slides, cartoon story books as well as posters were developed for both Chinese as well as other groups such as Malays, Ibans and Kayans. These were field tested and are now used in the Rejang Valley of Sarawak.

Human behavioural research applied to the leprosy control programme of Sarawak, Malaysia

In 1984, in Sarawak, there were a total of 1,099 recorded cases of leprosy for a population of 1.3 million. However, for each case recorded, it is estimated that two others remain undiagnosed as a consequence of the stigmatization associated with leprosy. For the five year period, 1979-1983, an average of 29 new cases were detected each year of which 8.6 (30%) were deformed due to the late stages at which it was being reported. To increase the case-finding rate, human behavioural research was applied to the leprosy control programme so as to develop culture-specific health education packages aimed at self diagnosis and self referral in order to detect the large pool of undiagnosed cases hidden behind the veil of aversion, fear and ignorance. This was achieved through anthropological studies to identify how the various major ethnic groups perceived leprosy and their attitudes towards leprosy. Taking into account these findings, health education packages aimed at adults as well as children were developed for the Chinese as well as the non-Chinese, and consisted of newspaper articles, cartoon tape-slides, cartoon story books and posters.

Alteration of nitrogenase activity of Anabaena CH1 and CH2 during light-dark transition

Nitrogenase activity decreased as cultures transferred from light to the dark. In anabaena CH1 nitrogenase activity ceased to near zero in two hours; but it took longer in Anabaena CH2. When darkened culture was placed again in the light, nitrogenase activity recovered in two hours. Hydrogen gas could protect this dark declination of nitrogenase activity. It is suggested that dark declination of nitrogenase activity is due to irreversible inhibition by oxygen which can not be omitted through oxidative respiration and/or oxyhydrogen reaction in the dark.

[Energy supply for nitrogen fixation of Anabaena sp. CH1 and CH2]

Energy needed for nitrogen fixation in Anabaena sp. has been studied. It was found that energy produced from photosynthesis but not from respiration was the main source for nitrogen fixation of Anabaena sp. CH1. In strain CH2, both photosynthesis and respiration supplied energy for nitrogen fixation. Some respiratory enzyme activities (IDH, MDH) were also higher in vegetative cells of strain CH2 than of strain CH1.

In vivo effect to uncoupler CCCP on nitrogenase of Anabaena sp. CH1 and CH2

Uncoupler CCCP inhibited the growth of Anabaena sp. CH1 and CH2 and reduced their photosynthetic rate and nitrogenase activity. It was determined that upon CCCP addition, nitrogenase activities of CH1 and CH2 declined to almost zero within 1 and 6 hours. Such decline may be caused by the direct inhibition of nitrogenase synthesis rather than by indirect interruption of the phosphorylation process.

Hepatocellular carcinoma in noncirrhotic patients. A laparoscopic study of 92 cases in Taiwan

Clinical and laboratory findings of 92 cases of pathologically verified noncirrhotic primary hepatocellular carcinoma (HCC) were analyzed and compared with that of 174 cases of cirrhotic HCC during the same period. Ninety-two cases of noncirrhotic HCC constitute one third of all the cases of HCC. They comprised 74 men (80.4%) and 18 women (19.6%) with a male:female ratio of 4.1. The mean age was 52.0 +/- 14.5 years. Among them, 17.4% had a history of hepatitis; 65.2% were HBsAg positive. Compared with cirrhotic HCC, patients with noncirrhotic HCC had less frequent past history of hepatitis, lower positive rate for HBsAg, higher albumin/globulin ratio, and lower frequency in the elevation of serum alpha-fetoprotein. The results might imply that noncirrhotic and cirrhotic HCC have different pathogenetic backgrounds.

Hepatocellular carcinoma in noncirrhotic patients. A laparoscopic study of 92 cases in Taiwan

Clinical and laboratory findings of 92 cases of pathologically verified noncirrhotic primary hepatocellular carcinoma (HCC) were analyzed and compared with that of 174 cases of cirrhotic HCC during the same period. Ninety-two cases of noncirrhotic HCC constitute one third of all the cases of HCC. They comprised 74 men (80.4%) and 18 women (19.6%) with a male:female ratio of 4.1. The mean age was 52.0 +/- 14.5 years. Among them, 17.4% had a history of hepatitis; 65.2% were HBsAg positive. Compared with cirrhotic HCC, patients with noncirrhotic HCC had less frequent past history of hepatitis, lower positive rate for HBsAg, higher albumin/globulin ratio, and lower frequency in the elevation of serum alpha-fetoprotein. The results might imply that noncirrhotic and cirrhotic HCC have different pathogenetic backgrounds.

Providing primary health care with non-physicians

The definition of primary health care is basically the same, but the wide variety of concepts as to the form and type of worker required is largely due to variations in economic, demographic, socio-cultural and political factors. Whatever form it takes, in many parts of the developing world, it is increasingly clear that primary health care must be provided by non-physicians. The reasons for this trend are compelling, yet it is surprisingly opposed by the medical profession in many a developing country. Nonetheless, numerous field trials are being conducted in a variety of situations in several countries around the world. Non-physician primary health care workers vary from medical assistants and nurse practitioners to aide-level workers called village mobilizers, village volunteers, village aides and a variety of other names. The functions, limitations and training of such workers will need to be defined, so that an optimal combination of skills, knowledge and attitudes best suited to produce the desired effect on local health problems may be attained. The supervision of such workers by the physician and other health professionals will need to be developed in the spirit of the health team. An example of the use of non-physicians in providing primary health care in Sarawak is outlined.

Segmentation by texture using correlation

The correlation coefficients are used for segmentation according to texture. They are first evaluated on a set of square regions forming two levels of the quadratic picture tree (or pyramid). If the coefficients of a square and its four children in the tree are similar, then that region is considered to be of uniform texture. If not, it is replaced by its children. In this way, the split-and-merge algorithm is used to achieve a preliminary segmentation. It is followed by a grouping algorithm using the correlation coefficients and the region adjacency graph, plus a small region elimination step. The latter regions are grouped according to their gray level because texture cannot be defined reliably on very small regions. Examples of implementation on four pictures are included.

Primary health care in rural China: post-1978 development

Primary Health Care in rural China is examined with particular reference to its development since 1978. The expansion and professionalization of the post-Mao rural health system is described and illustrated with examples from particular communes. The financing of the three-tiered health care system between 1967 and 1978 is described and some of the major problems in implementing current objectives are analyzed.

Behavioral pharmacologic studies in the monkey with DD-3480

A comparative study has been made of the catalepsy-inducing and antiapomorphine effects of DD-3480, a new butyrophenone derivative, and haloperidol in monkeys. DD-3480 exhibited catalepsy-inducing effects in a dose-dependent manner at oral doses of 2.5-10 mg/kg. This effect was comparable to that of haloperidol, but its duration was shorter in DD-3480 than in haloperidol. An evident anti-apomorphine effect was observed at 2.5 mg/kg of DD-3480 (p.o.); it was slightly stronger than that of haloperidol.