[Treatment of ocular injury with lensectomy and closed vitrectomy]

The authors reviewed 104 consecutive cases of ocular injury treated with lensectomy and closed vitrectomy including anterior segment resection in 80 cases and posterior segment, in 24 cases. The curative rate was 80.8%. Post-operatively, 44 eyes (47.8%) gained visual acuities of 0.025-0.6 and 68 eyes (65.4%) obtained visual improvement. 29 eyes were followed up 1-38 months, averaging 22.5 months, to find long-term therapeutic effects in 23 eyes (79.3%). The authors believe that lensectomy with closed vitrectomy is a useful modality in treatment of ocular injury.

[Management of dislocated or subluxated posterior chamber intraocular lens]

The experiences of the management of 20 cases (20 eyes) of intraocular lens (IOL) dislocation or subluxation were summarized in this report. All the patients underwent primary extracapsular cataract extraction with posterior chamber IOL implantation. The dislocation or subluxation occurred in 2 eyes intraoperatively and 18 eyes in 1 day to 3 years, post-operatively. The IOLs were captured at pupils in 12 eyes, dislocated into the vitreous in 4 eyes, represented as in westeast syndrome in 2 eyes and sunset and sunrise syndrome in 1 eye and 1 eye, respectively. Of the 20 eyes, 1 eye with mild sunset syndrome was treated with a miotic, 2 eyes with IOL pupillary capture were treated successfully by conservative therapy and the rest, by surgeries. In cases treated by operations, the IOLs were removed from original incisions in 3 eyes, by vitrectomies in 5 eyes and surgical reposition of IOLs were undertaken in 9 eyes with IOL pupillary capture of which 7 eyes were successful and in 2 eyes recurrence took place shortly after reposition. The causes and management of IOL dislocation or subluxation were discussed.

Maturational response of colonic and renal Na+,K(+)-ATPase activity to K+ load and betamethasone in preterm rats

Preterm human infants demonstrate high fecal K+/Na+ ratio that is inversely related to maturation. Renal and colonic basolateral membrane-located Na+,K(+)-adenosine triphosphatase (Na+,K(+)-ATPase) governs K+ excretion and is enhanced by both steroid administration and K+ loading. However, the response of premature kidney or colon to these stimuli is not well studied. We measured basal as well as stimulated levels of renal and colonic Na+,K(+)-ATPase activity in response to betamethasone and K+ load given separately and betamethasone given after K+ load in premature, mature, and 4-day-old Sprague-Dawley rats. Although preterm rats showed a higher basal level in the kidneys (p < 0.004), an increase in enzyme activity in response to the stimuli was achieved only in the colon (p < 0.001 for betamethasone, p < 0.0001 for K+ load, and p < 0.0007 for the combination). At term and at 4 days of postnatal age, however, the kidneys showed much higher levels than the colon in response to stimuli (p < 0.0001 for all) except for betamethasone at term. The response of colonic tissue of preterm and term rats to betamethasone given 4 days after a K+ load was less marked than response to betamethasone or K+ load given separately (p < 0.001). The stimulated levels achieved in the preterm colon were higher than the basal preterm renal values (p < 0.001). The tissue K+ content increased in response to K+ load in only the preterm colon (p < 0.05). We have demonstrated a tissue specificity in the development of Na+,K(+)-ATPase activity in K+ excretory organs of rats.(ABSTRACT TRUNCATED AT 250 WORDS)

Systemic amyloidosis. A report of 19 cases

Systemic amyloidosis is a rare disorder and usually occurs in aged persons with a poor prognosis. Certain mucocutaneous symptoms and signs may act as important clues for diagnosis. Skin or tongue biopsy may also provide important information to establish a firm diagnosis. During the past 14-year period, we found 19 cases of systemic amyloidoses: 8 (42%) with primary systemic amyloidosis, 8 (42%) associated with multiple myeloma and 3 (16%) were secondary amyloidosis. Ages of the patients ranged from 52 to 71 years with a mean age of 62 years at diagnosis. Median survival was only 8 months. Mucocutaneous manifestations were found in both primary type and myeloma-associated amyloidosis. In addition to the existence of amyloid in tongue and rectum biopsies in 17 cases and abdominal fat aspiration in 1 case, biopsies from clinically normal-looking skin also showed positive results in 18 out of 19 cases.

Alterations of G-protein coupling function in phosphoinositide signalling pathways of rat hippocampus by ischaemic brain injury

The activation of membrane-associated phospholipase C is rapidly and transiently induced in the central nervous system by a variety of stimuli. Ischaemic brain injury is one of the situations that leads to a dramatic increase in polyphosphoinositide (PPI) turnover. In this study, stimulation of PPI hydrolysis by glutamate (500 microM) was measured in hippocampal slices from rats up to 21 days after an ischaemic insult of 30 min. Ischaemia was induced using the four-vessel occlusion method. PPI hydrolysis elicited by glutamate was significantly increased in the slices prepared from ischaemic rats 24 h after reperfusion, the accumulation of inositol phosphates (InsPs) and inositol 1,4,5-trisphosphate (Insp3) was 614 +/- 74% (n = 8) and 182 +/- 11% (n = 9) of the basal level respectively. This potentiation was also observed 21 days after ischaemia. Hyper-responsiveness to glutamate was also accompanied by an increase in AIF4(-)-stimulated formation of [3H]inositol phosphates. In addition, global ischaemia did not change either high-affinity [3H]glutamate binding in hippocampal membranes or the stimulation of PPI hydrolysis by carbachol or noradrenaline in hippocampal slices. The present results suggest that the increased responsiveness to glutamate is the result, at least in part, of functional changes at the G-protein level, and may contribute to the pathophysiology of ischaemic brain injury or to the regenerative phenomena that accompany ischaemic damage.

[Study on the mechanisms of thrombin to inhibit neurite outgrowth]

In the present study, we investigated the effects and signal transduction mechanisms of thrombin on neuronal differentiation of human primitive neuroectodermal tumor cell line CHP-100. Thrombin inhibited neurite outgrowth of CHP-100 cells in culture induced by serum removal. The inhibitory effects were found to be associated with activation of phosphatidylinositol turnover/calcium mobilization signal transduction pathway by thrombin, since stimulation with thrombin induced significant inositol-1, 4, 5 trisphosphate accumulation and intracellular free calcium transient in CHP-100 cells. In addition, the most potent inhibitor of thrombin hirudin, which reversed the inhibitory effect of thrombin on neurite outgrowth of CHP-100 cells, also inhibited thrombin-stimulated calcium transient. These results suggest a specific role of thrombin signal transduction pathway in the regulation of neuronal differentiation.

[Treatment of rhegmatogenous retinal detachment complicated by vitreous hemorrhage]

8 cases of rhegmatogenous retinal detachment associated with vitreous hemorrhage were treated by first removing the blood through vitrectomy followed by routine retina reattachment procedures, such as searching for retinal breaks with indirect ophthalmoscopy and scleral buckling or encircling. Among 6 cases followed up, only 1 cases relapsed due to PVR traction. The points of note during operation were mentioned and the relationship between retinal breaks with vitreous hemorrhage and posterior vitreous detachment discussed.

[Sézary syndrome]

Sézary syndrome is a form of leukemia-lymphoma characterized clinically by erythroderma, pruritus, adenopathy, and circulating atypical cells with cerebriform nuclei. Histologically, atypical lymphocytes in the dermis and Pautrier's microabscesses are often present in skin biopsy specimens. We herein report a typical case of Sézary syndrome showing T-suppressor-cell characteristics, and related literatures are reviewed.

Repository dexamethasone in the treatment of acute bronchial asthma

Fifty-two patients with acute asthma requiring immediate therapy but not hospitalization were studied in an emergency department following conventional therapy with bronchodilators. After discharge, the patients were treated with a controlled regimen of long-acting theophylline and beta-agonist inhalation as necessary. They were randomly assigned to one of three groups using a double blind model. Group A received intramuscular and oral placebos. Group B received intramuscular dexamethasone injection along with oral placebo treatment. Group C received oral dexamethasone by a tapering schedule associated with placebo intramuscular injection. Follow-up was carried out 7 days after the treatment in the emergency room. There were no significant statistical differences in the relapse rate among the three groups. Those patients who received oral or intramuscular dexamethasone had a decrease in the need for beta-agonist inhalation and fewer respiratory symptoms. However, there was no significant statistical difference between groups B and C. It was concluded that repository steroids could reduce the respiratory symptoms and frequency of beta-agonist usage as effectively as oral steroid treatment. However, the steroids do not improve the relapse rate in patients with only mild symptoms.

[The investigation on 100 bronchial asthma and asthmatic bronchitis cases treated with high dose beclomethasone dipropionate aerosol]

100 cases, of which sixty four bronchial asthma patients and forty two asthmatic bronchitis patients sufficiently severe to be treated with inhaled corticosteroids, were investigated. All were treated with high dose beclomethasone dipropionate (BDP) inhaler aerosol (1500-2000 micrograms/day) for three months. The results showed the total effective rate was 98.4% in bronchial asthma patients and 62.5% in asthmatic bronchitis patients. The pulmonary functions and bronchial hyperresponsiveness of most bronchial asthmatic patients were improved significantly after 1-2 weeks treatment. It is recommendable to treat the oral cortisone-depending patients with BDP inhaler. After 3 months treatment, the adrenocortical secretive ability and reserve power of the patients could be slightly damaged. The investigation also showed 8 percent subjects complained of dysphonia and 25 percent suffered from oropharyngeal candidiasis. Finally, the asthmatic relapse rate was high after cessation of the therapy.

[Determination of glyciphosphoramide and its metabolite in plasma and the pharmacokinetics in rats after oral administration]

Glyciphosphoramide (GPA) is one of the anticancer agents belonging to the group of phosphoramide mustard. It has apparent antitumor effects in some animal models and in clinical trials against breast cancer, lymphosarcoma, uterocervical cancer and cancerous ulcer with good results. In this paper, the determination procedure of GPA and its metabolite using nitrobenzylpyridine (NBP) method is reported. The absorbance of the coloured products from the reaction of hydrolyzed or metabolized GPA with NBP was measured at 570 nm and 564 nm, respectively. The linearity of the reaction for GPA and its metabolite was established over the range of 6.25-100 micrograms/ml water or plasma. The plasma of rats and mice was found to be able to metabolize GPA to form alkylating agent (s) which react with NBP, but that of rabbits cannot. The plasma concentration-time curve of metabolite obtained after oral administration of GPA (100 mg/kg) in rats was shown to fit a two compartment open model with the following parameters: T1/2 beta = 44.5 min, T1/2 alpha = 3.16 min, T1/2 Ka = 2.14 min, T1/2Km = 0.0644 min, Tmax = 7.57 min, Cmax = 55.8 micrograms/ml, AUC = 2827. 39 micrograms/ml.min, K21 = 0.09663/min, K10 = 0.03535/min, K12 = 0.1030/min, Vc = 1.00 L/kg, Vd = 2.07 L/kg, CLt = 2.12 L/h. Kidney was found to be the main organ for GPA metabolite elimination. About one fourth of the given dose was excreted in urine within 24 h with the main portion excreted in the first 2 h.

A modified bidirectional decoding strategy based on the BAM structure

Based on the B. Kosko's bidirectional associative memories (BAM) strategy, a modified bidirectional decoding strategy (MBDS) is introduced. The MBDS structure provides sufficient recalling capabilities by adding some association fascicles to the BAM structure. These association fascicles are established with a relating parameter that controls the recalling performances. Pattern recognition examples are presented to shown that the MBDS requires considerably fewer weighting connections than the dummy augmentation method does. Moreover, in the problem of pattern recognition, if there are large number of trained pairs, the MBDS is still applicable, but the dummy augmentation method seems to be obstructed.

Mechanisms underlying chemoreceptor inhibition induced by atrial natriuretic peptide in rabbit carotid body

1. Previous studies in our laboratory revealed the presence of atrial natriuretic peptide (ANP) in preneural chemosensory type I cells of the cat carotid body, and demonstrated that submicromolar concentrations of the peptide inhibited carotid sinus nerve (CSN) activity evoked by hypoxia. In the present study, we have evaluated the role of the cyclic nucleotide second messenger, cyclic GMP (cGMP), and the involvement of type I cells in rabbit chemosensory inhibition. 2. Submicromolar concentrations of the potent ANP analogue, APIII, greatly elevated both the content and release of cGMP from the carotid body. Denervation experiments confirmed earlier immunocytochemical studies which suggested that APIII-induced cGMP production occurs almost exclusively in type I cells; these experiments also indicate that both the sympathetic and sensory innervation to the carotid body exert a trophic influence on the metabolism of this second messenger. 3. Submicromolar concentrations of APIII inhibited the CSN activity evoked by hypoxia (79.8 +/- 3.2% (mean +/- S.E.M.) inhibition with 100 nM APIII) and nicotine (74.5 +/- 3.6% inhibition with 100 nM APIII), but did not affect basal CSN activity established in 100% O2-equilibrated superfusion solutions. 4. The biologically inactive analogue of ANP, C-ANP, failed to produce CSN inhibition; however, the inhibitory effects of APIII were mimicked by cell-permeant analogues of cGMP (dibutyryl-cGMP and 8-bromo-cGMP, 2 mM), which likewise did not alter basal CSN activity. Because we found that unmodified cGMP was an ineffective inhibitor of CSN activity, our data suggest that APIII inhibition is mediated intracellularly by cGMP produced within the type I cells. 5. APIII does not inhibit the CSN activity produced by 20 mM K+ (in zero Ca2+ media), which very probably results from direct depolarization of the sensory nerve terminals. 6. Catecholamine release from the carotid body evoked by hypoxia is likewise not altered by APIII (100 nM). 7. The data are consistent with the notion that APIII and analogues of cGMP alter the release of excitatory and/or inhibitory transmitters from chemosensory type I cells in the carotid body.

[Surgical treatment of left ventricular right atrial fistula (II-type): report of 12 cases]

12 cases of left ventricular right atrial fistula (II-type) were identified and repaired by open heart surgery. Our date showed that defects of the septal leaflet of tricuspital valve can be divided into three groups: multiple-opening, single-opening and split defects. When there were VSD and fistula at the same position, the VSD was not repaired completely if the opening of tricuspital septal leaflet was mistaken as the VSD itself. It is important to expose the edge of the VSD completely by cutting tricuspital septal leaflet when repairing the VSD. The cutting septal leaflet can be sutured after closure of the VSD.

Atrial natriuretic peptide increases cyclic guanosine monophosphate immunoreactivity in the carotid body

The mammalian carotid body is a peripheral arterial chemoreceptor organ involved in the regulation of respiration, and in the modulation of blood pressure through reflex control of peripheral vascular resistance and cardiac output. In addition to its responsiveness to blood gases, the organ is also sensitive to hyperosmotic solutions, and we have recently shown that a systemic hormonal regulator of natriuresis and diuresis, atrial natriuretic peptide, is a potent inhibitor of chemoreceptor activity evoked by hypoxia in the cat carotid body. The present study demonstrates atrial natriuretic peptide immunoreactivity in type I cells of the carotid body, and shows further that a biologically active atrial natriuretic peptide fragment, atriopeptin III, increases cyclic guanosine monophosphate immunoreactivity in type I cells in a dose-dependent manner. Moreover, double-labeling techniques demonstrate co-existence of atrial natriuretic peptide immunoreactivity with the atriopeptin III-enhanced cyclic guanosine monophosphate reaction product. These findings indicate the probable existence of atrial natriuretic peptide receptors coupled to membrane-bound guanylate cyclase on the parenchymal type I cells. Our findings support the view that cyclic guanosine monophosphate functions as a second messenger in this organ, and may serve as a functional activity marker in identifying type I cells which respond to atrial natriuretic peptide.

Ion-exchanged Mach-Zehnder interferometers in glass

Ion-exchanged Mach-Zehnder interferometers are produced in glass. The effect of fabrication parameters on their optical response in relation to their constituent components is investigated.

Purification and characterization of an antiplatelet peptide, arietin, from Bitis arietans venom

By means of Fractogel TSK-50, CM-Sephadex C-50 column chromatography, gel filtrations on Sephadex G-75 and Sephacryl S-200 columns and reverse-phase HPLC, an antiplatelet peptide, arietin, was purified from venom of Bitis arietans. Arietin was shown to be an Arg-Gly-Asp-containing peptide with a NH2-terminus, Ser-Pro-Pro-Val-Cys-Gly-Asn-Lys- (Mr 8500). Arietin dose-dependently inhibited aggregation of human platelet suspension stimulated by ADP, thrombin, collagen and U46619 with IC50, 1.3-2.7.10(-7) M, while it had no effect on the initial shape changes and only slightly affected ATP release of platelets caused by thrombin and collagen. Arietin also blocked platelet aggregation in platelet-rich plasma and whole blood, and inhibited thrombin-induced clot retraction of platelet-rich plasma. Furthermore, arietin (6.5.10(-8) M) completely blocked the fibrinogen-induced aggregation of elastase-treated platelets, indicating that arietin interferes with the fibrinogen binding to fibrinogen receptors on platelet membranes. In conclusion, arietin, an Arg-Gly-Asp-containing peptide, inhibits platelet aggregation probably through the blockade of fibrinogen binding to the activated platelets.

Mechanism of action of the antiplatelet peptide, arietin, from Bitis arietans venom

Arietin, an Arg-Gly-Asp containing peptide from venom of Bitis arietans, inhibited aggregation of platelets stimulated by a variety of agonists with a similar IC50, 1.3-2.7.10(-7) M. It blocked aggregation through the interference of fibrinogen binding to fibrinogen receptors on platelet surface. In this paper, we further demonstrated that arietin had no significant effect on the intracellular mobilization of Ca2+ in Quin2-AM-loaded platelets stimulated by thrombin. It inhibited 125I-fibrinogen binding to ADP-stimulated platelets in a competitive manner (IC50, 1.1.10(-7) M). 125I-arietin bound to unstimulated, ADP-stimulated and elastase-treated platelets in a saturable manner and its Kd values were estimated to be 3.4.10(-7), 3.4.10(-8) and 6.5.10(-8) M, respectively, while the corresponding binding sites were 46,904, 48,958 and 34,817 per platelet, respectively. Arg-Gly-Asp-Ser (RGDS) inhibited 125I-arietin binding to ADP-stimulated platelets in a competitive manner. RGD-containing peptides, including trigramin and rhodostomin, EDTA and monoclonal antibody, 7E3, raised against glycoprotein IIb-IIIa complex, inhibited 125I-arietin binding to ADP-stimulated platelets, indicating that the binding sites of arietin appear to be located at or near glycoprotein IIb-IIIa complex. In conclusion, arietin and other RGD-containing trigramin-like peptides preferentially bind to the fibrinogen receptors associated with glycoprotein IIb-IIIa complex of the activated platelets, thus leading to the blockade of fibrinogen binding to its receptors and subsequent aggregation. The presence of RGD of arietin is essential for the expression of its biological activity. Its binding sites are overlapped with those of trigramin, rhodostomin and the monoclonal antibody, 7E3.

Brain-stem auditory evoked responses in 56 patients with acoustic neurinoma

The brain-stem auditory evoked responses (BAER's) recorded from 56 patients with acoustic neurinomas were analyzed. Ten of the patients had intracanalicular tumors and 46 had extracanalicular tumors. It was possible to obtain BAER's following stimulation of the affected side in 28 patients and after stimulation of the unaffected side in all 56. Five patients (11%) had normal BAER's following stimulation of both sides; three of these patients had intracanalicular tumors. Among BAER's obtained following stimulation of the affected ear, the mean interpeak latency (IPL) for peaks I to III associated with extracanalicular tumors was significantly prolonged relative to controls (p less than 0.001), and linear regression analysis revealed a significant positive correlation between tumor size and IPL of peaks I to III (p less than 0.05). Analysis of the 56 BAER's recorded after stimulation of the unaffected side revealed a significant positive correlation between the IPL's of peaks III to V and tumor size (p less than 0.001). This correlation was not strengthened when accounting for the degree of brain-stem compression. Finally, evidence of preserved function within the auditory pathway, even in the presence of partial hearing loss, is presented. This finding suggests that more patients might benefit from surgical procedures that spare the eighth cranial nerve.

The role of cyclic AMP in chemoreception in the rabbit carotid body

The present study identified physiological factors which influence the generation (and degradation) of cyclic AMP (cAMP) in the arterial chemoreceptor tissue of the mammalian carotid body. Experiments established a 3-way correlation between cAMP generation, neurotransmitter release from chemoreceptor cells, and carotid sinus nerve (CSN) activity. Incubation of carotid bodies in vitro for 10 min in media equilibrated with different low O2 ('hypoxic') gas mixtures (5% O2 or 10% O2, balance N2) elevated basal cAMP levels (100% O2 media) in proportion to the stimulus intensity. Similar experiments using nodose sensory ganglia showed that low O2 stimulation did not alter cAMP levels in this non-chemosensory tissue. However, the adenylate cyclase (AC) activator, forskolin (10 microM), evoked large increases in the cyclic nucleotide content in both carotid bodies and nodose ganglia. After chronic (10 days) CSN denervation or sympathectomy, the basal levels of cAMP in the carotid body were elevated; the cAMP response to low O2 media (stimulus minus control) was increased after CSN denervation but remained unaltered after sympathectomy. The effects of zero Ca2+ media on cAMP generation was examined in order to assess whether feedback from released neurotransmitters acting on known (presynaptic) type I cell receptors could have contributed to the observed changes in cAMP. Basal levels of cAMP were increased 2.8-fold, and the response to hypoxic stimulation was elevated 5-fold, in the absence of extracellular Ca2+. Forskolin (10 microM) did not alter basal release of [3H]-catecholamines ([3H]CA; synthesized from [3H]tyrosine), or resting CSN discharge; however, stimulus-evoked [3H]CA release and CSN discharge were potentiated in the presence of forskolin.(ABSTRACT TRUNCATED AT 250 WORDS)

Acral melanoma. A clinicopathologic study of 28 patients

Clinical and histopathologic analyses of 28 cases of acral melanoma in the last 24 years were carried out in this study. Of our 81 patients with cutaneous malignant melanoma, 28 (35%) had acral melanoma. The mean patient age was 59 years old. The two most commonly involved sites were the soles and toes. The preferential sites for metastasis were the lymph nodes, followed by the lungs, bone, and liver in descending order. Histologically, all skin biopsy specimens showed biphasic growth patterns and consisted of either spindle cells or epithelioid cells or both. The treatment was in all cases mainly surgical and, in patients at advanced stage, chemotherapy was added. The mean survival time for the series was 34.03 months, while the 3-year survival rate was only 29%.

Risk factors for stroke in rural areas of the People's Republic of China: results of a case-control study

A case-control study on stroke was carried out in 1985 in conjunction with a prevalence survey on neurologic disorders in 22 rural communities of the People's Republic of China. 585 cases of stroke, detected from the survey, together with an equal number of matched controls were investigated. The statistically significant factors associated with stroke in this study were: hypertension (history, findings at examination); high salt intake; family member(s) with cerebrovascular disease and/or hypertension; heart disease (history, abnormal findings at examination); history of transient ischemic attacks, and arteriosclerotic funduscopic findings. These factors were analyzed separately for hemorrhagic and ischemic strokes.

Use of fiberoptic bronchoscopy to retrieve bronchial foreign bodies in adults

The flexible fiberoptic bronchoscope was used to treat bronchial foreign bodies in 33 adults. The length of time that the foreign body was in the lung was less than 1 wk in six (acute group), more than 1 month in 21 (chronic group), and uncertain in two (uncertain group), and the foreign body was an endogenous broncholith in four patients (broncholith group). The foreign bodies were nonfragile, solid matter in most cases and they frequently had sharp projections on them. Granulations around the foreign body were common in the chronic group, but there was no correlation between the length of time the foreign body was in the lung and the amount of granulation or the number of the bronchoscopies needed for diagnosis or management. The granulations did not bleed easily on biopsy or during removal of the foreign body. In fact, they receded if several pieces were removed, making the foreign body much easier to recognize and to retrieve in the next bronchoscopy (about 1 wk later). After removal of the foreign body, the residual granulations regressed, and the bronchial lumen became more patent. The mortality, morbidity, and complication rates were very low, whereas the success rate was high. We conclude that flexible fiberoptic bronchoscopy is practical and safe in retrieving bronchial foreign bodies in adult patients.

[Effect of an essence-restoring decoction on DNA repair capacity]

In order to observe the effect on organism DNA repair capacity after administration of Essence-Restoring Decoction (ERD), the level of peripheral lymphocyte unscheduled DNA synthesis (UDS) in 20 healthy young men, 23 healthy old men and 13 old men given ERD were detected, while the frequency of sister chromosome exchange (SCE) of mice marrow cells in 80 ICR strain male mice were detected. Ultraviolet (UV) and mitomycin-C (MMC) were used as agents to induce injury of DNA. Experimental results showed that the level of UDS in the aged person was lower than that of the young person. Comparing the level of UDS of the aged before and after medication, it was shown that the level of UDS after medication was increased, approaching that of the young. Within a range of lower doses (less than 5mg/kg weight), the SCE value of mice marrow cells raised with the increase of MMC concentration, while this values was markedly lowered in the medicated mice as compared with that of the control. It is thus suggested that ERD could enhance the DNA repair capacity and this might be a part of the mechanism of "Invigorating Kidney and retarding aging" as indicated in TCM.

Effects of hypoxia on cyclic nucleotide formation in rabbit carotid body in vitro

The present experiments measured cAMP and cGMP in the arterial chemosensory tissue of the rabbit carotid body exposed for 10 min in vitro to normoxic or hypoxic conditions, or to specific activators of adenylate cyclase (forskolin) and guanylate cyclase (sodium nitroprusside). The enzyme activators elevated the basal levels of cAMP (48 x) and cGMP (3.7 x), respectively. Hypoxic media increased cAMP in the carotid body by 3.6-fold, but the levels of cGMP were reduced by 33% in media equilibrated with low O2. The data are consistent with the notion that cyclic nucleotides are involved in the transduction of natural stimuli and/or the neurotransmitter feedback modulation of chemosensory type I cells.

[Therapeutic research on kidney-tonifying herbs on the adrenocortical function in the aged]

The authors have observed the aging change of the adrenocortical function and the effect of the Kidney-tonifying herbs on such a change. The result showed that there was no statistical difference in the plasma cortisol levels between the aged and the young persons, and so was in the plasma corticosterone levels between the aged and the young rats. As the circulating steroids level depends on the balance of the secretion ability of the adrenal cortex and the peripheral degradation rate of the hormone, the authors measured the corticosterone concentration of the culture solution of the adrenocortical cells in vitro of the rats with different age to observe the secretion ability of the adrenocortical cell exclusively. The result showed that the corticosteróne concentration was significantly lower in the culture solution of the adrenocortical cell of the aged rats than that of the young rats, which suggests that the secretion ability of the adrenal cortex declines with aging. In addition, the authors determined the reserve power of the adrenal cortex with different age and found that the increased multiple of the salivary cortisol concentration 60 minutes after the stimulation of ACTH analogue was markedly lower in the aged persons than that in the young persons. The response of the cultured adrenocortical cells to secret corticosterone to the stimulation of ACTH analogue was also significantly lower in the aged rats than that in the young rats, which suggests that the reserve power of the adrenal cortex was also decreased with aging.(ABSTRACT TRUNCATED AT 250 WORDS)

The clinical manifestations of the tuberculous pleural effusion in adult patients

The clinical data of 52 patients with tuberculous pleural effusion were analyzed. Their average age was 48 years old. Thirty two (62%) of them were sick for less than one week. Fever, chest pain and cough were the predominant pictures. Six of the 52 patients had coexisting disease. Intermediate strength protein purified derivative (PPD) test was found to be positive in 14 out of 31 (45%) patients. Their pleural effusions were usually unilateral, right-sided, and nearly half of them occupied more than half of the hemithorax. One third of these patients and concomitant pulmonary tuberculosis and pleural effusion. None of the patients had grossly bloody effusion. All of the effusions were exudative, and the glucose levels in the pleural fluid were invariably above 60 mg/dl. Presence of mesothelial cells in the pleural fluid was found in 28% of them, but none of the patients presented with significant eosinophils in the pleural fluid. Pleural fluid and sputum cultures for Mycobacterium tuberculosis usually reveal a negative study unless a concomitant pulmonary lesion was present. Combined antituberculosis and prednisolone treatment decreased the duration of constitutional symptoms and hastened the resolution of pleural effusion. In conclusion, tuberculous pleural effusion should be considered in elderly patients presenting with massive exudative pleural effusion even with a negative PPD study. Cultures of sputum and pleural fluid are less helpful in patients without parenchymal disease. Prednisolone is recommended in extremely ill patients.

Prevention of hypothermia during abdominal surgery: comparison of thermal tube and blanket

Twenty patients who received elective abdominal surgery for more than two hours were randomly assigned into two groups. Group 1 was warmed by using "EXACON" thermal therapy system model TT8200. Group 2 was warmed by using a thermal blanket of aquamatic K-thermia (electronic control), model PK-600 of American Hamilton medical systems. Other variables were kept constant, and the theater temperature was maintained at 24 degrees C. Core temperature was recorded every five minutes in a two hour period. There were statistically significant differences between these two groups intra-operatively. Decrease of temperature between these two groups had significant changes from 30 minutes to 2 hours (p less than 0.05). The warming effect of esophageal thermal tube was well controlled by directly warming the central compartment. However, the effect of blanket was unpredictable due to wet dressing and superficial warming of surgical fields. There were no side effects during the study.

Airway lesions presenting with a normal chest X-ray

From August 1980 to December 1987, 2,020 patients were proved by bronchoscopy to have endobronchial lesions at Chang Gung Memorial Hospital, Taipei. The chest roentgenograms, reviewed by 2 thoracic physicians and 1 radiologist, were reported to be normal in 31 of these patients. The incidence of airway lesions with a normal chest X-ray was 1.5% (31 out of 2,020 cases). These 31 patients included 18 males and 13 females, and their ages ranged from 7 months to 75 years with a mean of 40.3 years. The leading diseases in these cases were tracheal cancer (8 cases), tracheal and/or bronchial tuberculosis (6 cases), bronchogenic carcinoma (5 cases), tracheal schwannoma (2 cases), tracheal cyst (1 case) and bronchial adenoma (1 case). The trachea and main bronchi were the two most frequent sites of radiologically occult endobronchial lesions. Although the majority of the lesions occupied more than 50% of the diameter of the airway lumen, they were not well demonstrated in the routine chest radiological studies. Location, size and nature of the lesions were the major consideration that contributed to the normal-looking appearance of the chest X-ray. Alertness to the symptoms, physical signs and clinical history led to further investigation and the final diagnosis. The conclusion is that some airway lesions may present with a normal chest X-ray and delay the diagnosis. Careful history taking and observation of clinical symptoms and signs are important in the final diagnosis of these patients.

Corticosteroids in the treatment of tuberculous pleurisy. A double-blind, placebo-controlled, randomized study

A prospective, double-blind, randomized study of the role of corticosteroids in the treatment of tuberculous pleurisy was performed in 40 patients. All patients received adequate antituberculosis chemotherapy (isoniazid, 300 mg/day; rifampin, 450 mg/day; ethambutol, 20 mg/kg/day) for more than nine months. They were randomly assigned to take prednisolone 0.75 mg/kg/day orally or placebo for the initial treatment, which was tapered gradually for the next two to three months. Twenty-one were treated with steroids and 19 were given a placebo. The two groups were identical with regard to age, sex, duration from onset of symptoms to diagnosis, and initial amount of pleural effusion. The mean duration from symptoms (fever, chest pain, dyspnea) to relief was 2.4 days in the steroid-treated group, and 9.2 days in the placebo group (p less than 0.05). Complete reabsorption of pleural effusion occurred an average of 54.5 days in the steroid-treated group and 123.2 days in the placebo group (p less than 0.01). The development of residual pleural thickening was not influenced by the administration of corticosteroids. No serious side effects were noted during the treatment in either group. We conclude that the administration of corticosteroids, in conjunction with antituberculosis chemotherapy, will resolve the clinical symptoms more quickly and hasten the absorption of pleural effusion in patients with tuberculous pleurisy.

Riu's stain in the diagnosis of pulmonary cryptococcosis. Introduction of a new diagnostic method

Pulmonary cryptococcosis is thought to be a rare disease. Clinically, it presents no characteristic symptoms, signs or chest x-ray film findings. Most of the reported cases of pulmonary cryptococcosis were not diagnosed either antemortem or before surgical intervention. A simple diagnostic method, Riu's stain, can be used routinely in bronchoscopic brushing smears, or for needle aspiration cytologic studies, making pulmonary cryptococcosis easy to diagnose.

Fiberoptic bronchial blockade in a small bronchopleural fistula

A patient with bronchopleural fistula was successfully treated by selective intrabronchial injection of doxycycline and blood under fiberoptic bronchoscopic guidance. This simple and relatively noninvasive therapeutic approach is an effective and safe alternative in treating selective patients with a bronchopleural fistula.

Survey of periodontal disease among workers in Tianjin using Ramfjord's Periodontal Disease Index (PDI)

An epidemiologic study of periodontal disease according to Ramfjord's PDI among 2284 workers was performed in Tianjin in 1982. This study included 1066 men and 1218 women, aged 18-50. The prevalence of gingivitis and periodontitis was 89.5% and 44.4%, respectively. Only 28 workers were free from periodontal disease. Gingivitis and periodontitis were highly prevalent in both sexes, but men had more severe gingivitis and periodontitis than women. The better oral hygiene of the women may account for this difference.

Cutaneous leishmaniasis. Clinical, histopathologic, and electron microscopic studies

One Chinese construction worker and a Chinese cook experienced unknown insect bites during their stay in Abha of Saudi Arabia and then developed skin ulcers. After returning to Taiwan, Republic of China, they were diagnosed in our hospital as having cutaneous leishmaniasis on clinical and dermatopathologic grounds. We were successful in culturing the Leishmania organism with Tobie medium and liquid metacyclic stage culture medium from the skin ulcers of these two patients. The electron microscopic findings of the parasites, Leishmania tropica, both in the tissue (amastigote) and in the cultured medium (promastigote), were also reported.