[Evaluation of staging conformity CTNM and PTNM for lung cancer]

A series of 225 consecutive lung cancer patients were prospectively randomized into study group (75 patients) and control group (150 patients), and the conformity of CTNM and PTNM staging was was evaluated. Radical mediastinal lymph node dissection was performed and in average 11.5 nodes were dissected in the study group. Only suspected metastatic lymph nodes, 3.4 in average, were dissected in the control group. CTNM classification was made according to clinical examination, chest image examination and bronchoscopy in every patient and PTNM staging was made after thoracotomy. Then the conformity of CTNM and PTNM staging was examined by Kappa value. The results showed that the Kappa value in the two groups was lower than the effective standard value of 0.4. The study group (Kappa = 0.097) was poorer than the control group (Kappa = 0.371). The principal influencing cause was that N was not well evaluated by CTNM. The principal manifestation of the staging inconsistency was that the stage of PTNM was advanced than that of CTNM. In the study group 43% of patients showed an increased stage and this occurred in 33% of the control group (P < 0.05). The results of the study show that at present the CTNM staging has not fully satisfied the needs of practice and requires to be further improved. The operative procedure which only dissects suspected involved mediastinal lymph nodes can not meet the needs of PTNM staging. In order to make PTNM staging accurately and evaluate the results of treatment for lung cancer, radical mediastinal lymph node dissection should be performed in every operable patient.

Expression of hepatocyte growth factor is up-regulated through activation of a cAMP-mediated pathway

Hepatocyte growth factor (HGF) is a multifunctional cytokine with mitogenic, motogenic, morphogenic, and tumor-suppressing activities. Despite the broad spectrum of its biological activities, HGF is most likely the physiological hepatotrophic factor that triggers or modulates liver regeneration. Regulatory mechanisms for HGF production are crucial for understanding the control of liver regeneration. We previously reported that HGF production by human skin fibroblasts is stimulated by a protein kinase C (PKC)-mediated pathway. We determined here whether gene expression and production of HGF in human skin fibroblasts can be induced via activation of a cAMP-mediated pathway. HGF secretion by the cells was markedly stimulated by the cAMP-elevating agents, forskolin, cholera toxin, prostaglandin E2 (PGE2), and 3-isobutyl-1-methylxanthine, as well as by the membrane-permeable cAMP analogues, 8-bromo-cAMP and dibutyryl cAMP. The dose-response curves of induction of HGF secretion by cholera toxin and forskolin were nearly parallel with those of the intracellular cAMP levels. HGF mRNA levels did not significantly increase at 5 and 10 h, but increased considerably 15 h or more after the addition of cholera toxin. Forskolin, 8-bromo-cAMP, and PGE2 also caused appreciable up-regulation of HGF gene expression with a similar time course. Although human skin fibroblasts of various origins secreted variable amounts of HGF, the cAMP-elevating agents and the cAMP analogues caused a very marked increase in HGF production in all of them. The agents also enhanced highly active HGF secretion by MRC-5 human embryonic lung fibroblasts. Dexamethasone and transforming growth factor-beta 1, which inhibit PKC-mediated HGF secretion, down-regulated HGF mRNA expression and HGF production in the cells treated with the cAMP-elevating agents and the cAMP analogues. These results indicate that HGF expression in human skin fibroblasts is stimulated by activation of a cAMP-mediated pathway.

Right pulmonary artery arising from ascending aorta: report of a successfully treated case

A nine-day-old neonate presented with signs of congestive heart failure during the first week of life. The echocardiogram showed an early bifurcating great vessel originating from the left ventricle. In addition, there was another vessel originating from the right ventricle directly connected to the descending aorta without early branching into the bilateral pulmonary arteries. A muscular ventricular septal defect (VSD) was also found. Cardiac catheterization and angiography showed that: 1) the anomalous origin of the right pulmonary artery arose from the ascending aorta; 2) a large patent ductus arteriosus (PDA) connected the main pulmonary artery and the descending aorta; and 3) a muscular VSD existed. Magnetic resonance imaging also demonstrated the above findings. Reimplantation of the anomalous right pulmonary artery to the main pulmonary artery and ligation of the PDA were done. To the best of our knowledge, this very unusual case is the first such neonatal case with successful surgical repair in Taiwan.

A comparative study of growth hormone (GH) and GH-releasing hormone(1-29)-NH2 for stimulation of growth in children with GH deficiency

In this study, 60 patients with proven growth hormone deficiency (GHD) of hypothalamic origin were randomized into three equal groups, and received growth hormone-releasing hormone(1-29)-NH2 (GHRH(1-29)-NH2), 30 or 60 micrograms/kg/day, or growth hormone (GH), 0.1 IU/kg/day, for 6 months. There were no significant differences in growth between the two groups given GHRH(1-29)-NH2, but growth in the GH group was significantly better than in the other two groups (p < 0.01). Mean height velocities at 6 months were 9.2, 9.3 and 14.6 cm/year for the three groups, respectively. Plasma GHRH concentrations increased steadily over the 6-month treatment period, with higher levels in the group on the higher dose. During GHRH(1-29)-NH2 treatment, serum concentrations of insulin-like growth factor I rose initially, but then fell to values similar to those before treatment. No GH antibodies were detected, but all 20 patients on high-dose GHRH(1-29)-NH2 and 19 of 20 patients on low-dose GHRH(1-29)-NH2 developed GHRH antibodies. These had almost disappeared by 9 months after stopping treatment. There was no correlation between antibody titres and increase in height. No serious side-effects were seen, but three patients receiving GHRH(1-29)-NH2 reported mild irritation at the injection site. These results from the continuous infusion of GHRH(1-29)-NH2 over 6 months suggest that this treatment, or the related use of a depot preparation, is unlikely to be as effective as GH for the promotion of growth in GHD.

[The effects of polylysine on the aggregation of surface and on the cleavage furrow of Rana amurensis eggs]

Polylysine synchronously aggregated pigment granules and egg surface stained uniformly with fluorescein isothiocyanate to form patches (Plate I, fig 1 & 2). Patches always appeared and aggregated first in the opposite grey crescent region, then in grey crescent region and next at animal hemisphere. A fluorescent ring formed at the upper side of the equatorial region. The ring and the patches at the animal hemisphere accumulated to the animal pole to make a cap (Plate I, Fig. 3). Finally the vegetal hemisphere broke due to the contraction of egg surface during aggregation. These indicated that four different domains: opposite grey crescent region, grey crescent region, animal and vegetal hemispheres, were present at the fertilized egg surface. Similar domains also occurred at the unfertilized egg surface as revealed by the same treatment suggesting that the opposite grey crescent region of fertilized egg, which corresponding to the sperm entrance region had existed at the mature egg surface. There were three modes in the early stage of patch formation: (1) the features of granular protrusions did not change greatly (Plate I, Fig. 5-7), (2) the granular protrusions elongated (Plate I, Fig 8-11) and (3) folds radiated from patch (Plate I, Fig. 12, 13). Around each patch new surface membrane arose, which was similar to the nascent membrane of cleavage furrow.(ABSTRACT TRUNCATED AT 250 WORDS)

[Evaluation of the panoramic sialography in the diagnosis of salivary gland diseases]

Pantomographic sialography (PS) and traditional sialography (TS) was performed and compared on 106 glands out of 94 patients. The main advantages of pantomographic sialography are: (1) sialectasic lesions of the salivary glands are shown well; (2) small lesions of the main salivary glands are shown well: (3) lesions of the main salivary ducts are shown well; (4) the imaging distortions are minor and the actual situation can be demonstrated well; (5) superimposition of surrounding tissues is avoided, the imagings are more clear; (6) more than one glands can be examined at the same time; and (7) patients are positioned easily and feel more comfortable.

Detection of human papillomavirus DNA sequences in cervical lesions by in situ hybridization using biotinylated DNA probes

Ninety-six biopsy specimens were collected for studying the association of specific sequences of HPV DNA with genital warts, precancerous lesions and invasive cervical cancer. Using DNA probes labeled with biotin, 17 of the 22 (77.27%) specimens showing condyloma and 1 of the 14 (7.14%) specimens displaying subclinical papillomavirus infection (SPI) of cervix were found to be positive for HPV 6/11; 4 of 23 (17.39%) specimens of squamous epithelial cervical cancer and 2 of the 23 (8.70%) specimens of cervical intraepithelial neoplasia (CIN) were positive for HPV 16/18. All the 14 specimens of cervicitis were negative for both probes. The HPV 6/11 positive hybridization products were present mainly in the superficial and intermediate epithelium of condyloma and SPI. In invasive cancer, HPV 16/18 were shown more often in cancer cells of infiltrative nests and were focally distributed.

Internally standardized amino acid analysis for determining peptide/carrier protein coupling ratio

A method based on amino acid analysis has been developed for monitoring the covalent conjugation of synthetic peptide haptens to carrier proteins. The marker amino acid, alpha-aminobutyric acid, is included in the sequence during peptide synthesis. Following reaction, the carrier protein-conjugate is freed of excess peptide by two successive rounds of gel filtration chromatography. Amino acid analysis of a hydrolysate of the conjugate allows the calculation of the coupling ratio of the peptide to the carrier protein. Two typical procedures for conjugation, carbodiimide cross-linking and cysteine-thiol reaction with maleimidyl-proteins, have been evaluated.

Location of ion-binding sites in the gramicidin channel by X-ray diffraction

We report the first X-ray diffraction on gramicidin in its membrane-active form by using uniformly aligned multilayer samples of membranes containing gramicidin and ions (T1+, K+, Ba2+, Mg2+ or without ions). From the difference electron density profiles, we found a pair of symmetrically located ion-binding sites for T1- at 9.6 (+/- 0.3) A and for Ba2+ at 13.0 (+/- 0.2) A from the midpoint of the gramicidin channel. The location of Ba(2+)-binding sites is near the ends of the channel, consistent with the experimental observation that divalent cations do not permeate but block the channel. The location of T1(+)-binding sites is somewhat of a surprise. It was generally thought that monovalent cations bind to the first turn of the helix from the mouth of the channel. (It is now generally accepted that the gramicidin channel is a cylindrical pore formed by two monomers, each a single-stranded beta 6.3 helix and hydrogen-bonded head-to-head at their N termini.) But our experiment shows that the T1(+)-binding site is either near the bottom of or below the first helix turn.

Custom lip shield for chronic actinic cheilitis

Chronic actinic cheilitis is a premalignant lesion related to excessive exposure to the sun. Those with fair complexions and blond hair, and those who work outside are susceptible to this disease. This article describes the fabrication of a custom lip shield to protect the lower lip from the sun in highly susceptible individuals.

Comparison of weight reduction in different designs of solid and hollow obturator prostheses

Seven types of the partially edentulous maxillectomy arches based on Aramany's classification were designed to evaluate the weight reduction of hollow obturator prostheses. Six obturator prostheses were made for each type of maxillary defect, three of the solid type and three of the hollow type. The weight of each of the 42 obturator prostheses was measured and all of the data were collected and statistically analyzed. The results showed that the hollow obturator prostheses had significantly increased weight reduction, from 6.55% to 33.06% depending on the size of the defect.

Percutaneous superfine-needle aspiration biopsy of intrathoracic lesions guided by simulator

The result of percutaneous superfine-needle aspiration biopsy in 100 patients with intrathoracic lesions guided by simulator is reported. The success rate of aspiration biopsy was 94%, and no major complication was observed. The method of localization by simulator had advantages such as accuracy in localization, no limitation of mass size and site, and a high rate of puncture success. Cell smears obtained by superfine needle were similar to those obtained by fine- or large-bore needles, but fewer complications were encountered. This is a useful technique that can provide early cytological diagnosis, especially for the peripheral type of pulmonary mass.

An outbreak of epidemic diarrhoea in adults caused by a new rotavirus in Anhui Province of China in the summer of 1983

Shexian County of Anhui Province in East China experienced a severe outbreak of nonbacterial diarrhoea in May and June of 1983. Over 20,0000 cases were reported. Most were adults of 20 to 50 years old. The isolated virus was morphologically indistinguishable from ordinary infantile rotavirus, but CF and ELISA tests showed that the new virus lacked the common group-A antigen shared by ordinary rotavirus. Nine of 10 convalescent-phase and three paired sera of patients showed antibody positive, with a greater than four-fold antibody rise against new rotavirus in the CF test. Seventeen faecal samples from patients showed identical, and special, electropherotype. They all had a double-stranded RNA with 11 discrete segments. The RNA profiles were quite different from those of reference rotavirus Wa strain and ordinary infantile rotaviruses. Third and 4th segments were near to each other, 5th and 6th segments were very close, but 7th, 8th, and 9th segments were widely separated. This study indicates the new virus can be identified as part of a new group of rotaviruses. This new rotavirus has been incriminated as the causative agent of the epidemic.

Epidemiological studies of hemorrhagic fever with renal syndrome: analysis of risk factors and mode of transmission

During an outbreak of hemorrhagic fever with renal syndrome in the Anhui Province of China, a door-to-door survey was conducted of all of the 10,024 residents of eight village communities. The incidence rates were higher in males than in females and higher in adults than in children. Of all the residents surveyed, however, those who had slept on the ground or had been engaged in heavy farm work were at a significantly higher risk of illness than were those who slept on wooden beds or did light work. Among men who did heavy farm work and who gave a history of sleeping in straw huts on the drained swamp, the attack rate was 2.33 times higher than it was for those sleeping exclusively in their permanent homes. Among both sexes, threshers had a significantly higher attack rate than did nonthreshers. Suspicions that trombiculid mites or gamasoid mites act as vehicles of transmission cannot be accepted as an explanation for the association of the risk of illness with the type of work done and with sleeping arrangements. Circumstantial evidence supports our hypotheses of airborne transmission and transmission by inoculation of infectious materials into skin lesions.

Observation on erythrocyte acetylcholinesterase (AChE) in infants and children with Hirschsprung's disease

In 31 cases of Hirschsprung's disease, the mean value of erythrocyte AChE activity was discovered to be 91.24 +/- 10.24 u/mL, being significantly higher than that from 127 normal children of 73.51 +/- 9.36 u/mL (P less than 0.001); whereas serum ChE mean value of 14.49 +/- 4.04 u/mL showed no difference from normal control (16.89 +/- 8.86 u/mL, P greater than 0.05). In addition, the erythrocyte AChE activity of six newborns with Hirschsprung's disease was also found to be much higher than its own normal control. It was therefore, concluded that this assay may be of supplementary diagnostic significance in diagnosing neonatal Hirschsprung's disease.