[Analysis of differences and influencing factors of liver injury associated with different strains of 2019-nCoV infection]

Objective: To analyze whether there are differences and related influencing factors in liver injury associated with different strains of 2019-nCoV/SARS-CoV-2 infection. Methods: Data of epidemiology, clinical symptoms, laboratory tests, and treatment outcomes of patients with COVID-19 infection confirmed with Alpha and Delta virus strain in Zhejiang Province were retrospectively collected. Statistical analysis was performed using independent samples t-test or Mann-Whitney U test, χ² test or Fisher's exact test, and logistic regression analysis. Results: A total of 788 and 381 cases with Alpha and Delta virus strain were included. Vaccination ratio was 0% in Alpha and 85.30% in Delta group (P<0.001), The proportion of patients with fever (80.71% vs. 40.94%, P<0.001) was significantly higher in Alpha than Delta strain group. The proportion of critical ill patients was significantly higher in Delta group (9.90% vs. 1.57%, respectively, P<0.001). The virus negative conversion time was significantly longer in Delta than Alpha group (22 d vs. 11 d, P<0.001), but the incidence of liver injury was significantly higher in Alpha than Delta group (20.05% vs. 13.91%, P=0.011). Univariate analysis showed that Alpha virus strain infection, male sex, body mass index, chronic liver disease, fever, diarrhea, shortness of breath, severe/critical illness, elevated creatine kinase (CK), elevated international normalized ratio (INR) and an elevated neutrophil/lymphocyte ratio was significantly associated with an increased risk of liver injury occurrence, and in patients with pharyngeal pain the risk of liver injury occurrence was significantly reduced. Multivariate analysis showed that shortness of breath [OR, 2.667 (CI: 1.389-5.122); P=0.003], increased CK [OR, 2.544 (CI: 1.414-4.576); P=0.002] and increased INR [OR, 1.721] (CI: 1.074-2.758); P=0.024] was significantly associated with an increased risk of liver injury occurrence, and in patients with pharyngeal pain the risk of liver injury occurrence was significantly reduced [OR, 0.424 (CI: 0.254-0.709); P=0.001]. Conclusion: Although the virulence of the Delta is stronger than Alpha strain, most patients infected with Delta strain vaccinated against COVID-19 in Zhejiang province had milder clinical symptoms and a lower incidence and degree of liver injury. Notably, the infection risk even remains after vaccination; however, symptoms and the incidence of severe and critical illness can be significantly reduced.

[Efficacy and safety of Entecavir monotherapy switched from Lamivudine combined Adefovir Dipivoxil for chronic hepatitis B virus-related compensated liver cirrhosis]

Objective: To observe the efficacy and safety of de novo combination of Lamivudine(LAM) and Adefovir Dipivoxil (ADV) therapy counter to Entecavir (ETV) monotherapy in patients with chronic hepatitis B (CHB)- related compensated liver cirrhosis. Methods: Patients with chronic hepatitis B-related compensated cirrhosis who were initially treated with LAM and ADV for more than 1 year were randomly assigned to two groups, one half replaced with ETV monotherapy, and the other half continued LAM and ADV co-therapy. Liver biochemistry, renal biochemistry, estimated glomerular filtration rate, alpha-fetoprotein, HBV serology markers and serum HBV DNA were measured every 3 months. Urine β2-microglobulin was measured every 6 months And retinol binding protein, followed up for 3 years. The mean values of the two groups were compared with t-test, and the rate of comparison was analyzed by x2 test. Results: A total of 580 cases were collected, 290 cases were replaced with ETV monotherapy, the other 290 patients continued to LAM and ADV combination therapy. In the ETV group, the rates of HBV DNA negative conversion at 1 year, 2 years and 3 years were 77.6%, 84.5% and 94.5% respectively, while the HBV DNA negative conversion rates at 1, 2 and 3 years in the LAM and ADV combination groups were 69.3%, 73.4% and 80.3% respectively. Among them, the negative rates of HBV DNA in the second year and the third year were P < 0.05, the difference was statistically significant. The 3-year cumulative gene-resistant rate in the ETV group was 1.4%, while the combined treatment was as high as 8.6%, and the difference was statistically significant in the two groups. The estimated value of serum creatinine and glomerular filtration rate in ETV group was followed by 3 years, and the baseline level was maintained, in the same group, the serum creatinine was higher than baseline, and the estimated value of glomerular filtration rate decreased. The results showed that there were 6.2%, 12.1%, 22.1% and 0, 0.3%, 1%, respectively, in 1, 2 and 3 years for the group of consecutive treatment and the replacement of ETV Group. The estimated glomerular filtration rate decreased by more than 30% compared with the baseline. The difference was statistically significant; the proportion of serum creatinine in the 1 year, 2 years and 3 years of the combined treatment group was 1.7%, 4.5% and 6.6%, compared with the baseline rise of > 50 μmol/l, and the ETV group was replaced in the 1 year, The values of 2 and 3 years were 0,0,0.7%, of which the 2nd and 3rd years were statistically significant; the proportion of microalbuminuria and retinol-binding protein in patients with combined treatment group was also significantly higher than that of Β2-m ETV Group. Conclusion: The initial combination of LAM and ADV therapy is inferior in terms of ETV monotherapy. Single therapy with ETV increase the rate of viral response, reduce the incidence of drug resistance, and also reduce the incidence of renal impairment in patients with chronic hepatitis B -related compensated liver cirrhosis.

Diagnostic value of transvaginal four-dimensional hysterosalpingo-contrast sonography combined with recanalization in patients with tubal infertility

Background

A retrospective study was designed to evaluate the diagnostic value of transvaginal four-dimensional hysterosalpingo-contrast sonography (TVS 4D-HyCoSy) combined with recanalization versus laparoscopy for patients with tubal infertility.

Materials and Methods

A total of 195 patients undergoing TVS 4D-HyCoSy were analyzed retrospectively. Of these, 72 patients underwent laparoscopy, which was the gold standard. The endpoints were coincidence rate (defined as a parameter consistent with results arising from TVS 4D-HyCoSy and laparoscopic examination using dye), sensitivity, specificity, positive predictive value, negative predictive value, and Youden index for TVS 4D-HyCoSy.

Results

A total of 385 fallopian tubes were assessed by TVS 4D-HyCoSy, of which 147 (38.2%) were tubal patency, 178 (46.2%) as partial tubal obstruction, and 60 (15.6%) as complete tubal obstruction. Of 195 patients, 72 patients with 144 fallopian tubes underwent laparoscopy and a total coincidence rate of 90.97% compared with TVS 4D-HyCoSy. The sensitivity, specificity, positive predictive value, negative predictive value, and Youden index for 4D-HyCoSy versus laparoscopy were 97.7%, 86.7%, 98.4%, 81.3%, and 0.84, respectively.

Conclusions

TVS 4D-HyCoSy represents a highly useful method for diagnosing tubal patency. However, further large-scale studies are warranted to investigate our findings in patients with tubal infertility.

[The association between the malnutrition and blood pressure in Chinese Han students aged 7-18 years in 2014]

Objective: This study aimed to explore the association between malnutrition and the level of blood pressure (BP) as well as elevated BP (EBP) in Han students aged 7 to 18 years in China. Methods: 170 037 subjects with normal nutritional status and malnutrition were enrolled in this study from 2014 Chinese National Surveys on Students' Constitution and Health with a multi-stage stratified cluster random sampling framework covering 31 provinces, autonomous regions and municipalities after the exclusion of 44 317 overweight and obese students. According to the standard of "Screening Standard for Malnutrition of School-age Children and Adolescents" (WS/T456-2014), the nutritional status of children were classified into two categories, normal nutritional status and malnutrition containing stunting, mild wasting and moderate severe wasting. The level of BP and prevalence of EBP were compared between students with normal nutritional status and malnutrition. The multivariate logistic regression model was used to analyze the association between malnutrition and EBP. Results: The levels of systolic BP (SBP) and diastolic BP (DBP) in Chinese Han students aged 7-18 years who were non-overweight and non-obesity status were (103.4±12.3) and (64.7±9.5) mmHg (1 mmHg=0.133 kPa), respectively. The prevalence of EBP, systolic EBP and diastolic EBP in Chinese Han malnourished students (N=21 012) were 3.1% (n=649), 1.5% (n=324) and 2.1% (n=445), respectively, which was significantly lower than those (N=148 320) with normal nutritional status (4.5% (n=6 707), 2.6% (n=3 872) and 2.7% (n=3 959)), and the corresponding differences were statistically significant (P<0.05). The OR (95%CI) between malnutrition and EBP was 0.68 (0.62-0.73), which were 0.65 (0.58-0.72) and 0.68 (0.60-0.77) for boys and girls. The OR (95%CI) between EBP and stunting as well as mild wasting and moderate severe wasting were 0.69 (0.62-0.77), 0.63 (0.55-0.72) and 0.79 (0.60-1.05), respectively. Conclusion: The level of BP and prevalence of EBP in Chinese Han students with malnutrition were lower than those with normal nutritional status. The negative correlation existed between malnutrition and EBP in Chinese Han students aged 7 to 18 years.

[The epidemiological characteristics and related factors of dyslipidemia among children and adolescents aged 6-17 years from 7 provinces in China, 2012]

Objective: To investigate the prevalence and related factors of dyslipidemia among children and adolescents aged 6-17 years in 7 provinces in China. Methods: Using the method of stratified cluster random sampling, 93 primary and secondary schools were selected from Guangdong, Hunan, Liaoning provinces, Shanghai, Chongqing, Tianjin municipalities and Ningxia Hui Autonomous Region in China, 2012. A total of 16 434 students aged 6-17 years old with completed physical and lipid profiles parameters were selected into this study from above 93 primary and secondary schools. Dyslipidemia was determined by the definition of Expert Advice on Prevention and Treatment of Dyslipidemia in Children and Adolescents in 2009. Logistic regression model was used to explore the factors related to dyslipidemia. Results: The prevalence of elevated total cholesterol, elevated triglyceride, elevated low-density lipoprotein cholesterol, low high-density lipoprotein cholesterol, and dyslipidemia was 5.4% (887 cases), 15.7% (2 578 cases), 3.0% (492 cases), 13.5% (2 221 cases) and 28.5% (4 679 cases) among children and adolescents aged 6-17 years, respectively. Sugary drinks intake ≥once per week (OR=1.14; 95%CI: 1.05-1.24), sedentary time >10 hours per day (OR=1.14, 95%CI: 1.01-1.28), overweight (OR=1.50, 95%CI: 1.33-1.70), and obesity (OR=2.62, 95%CI: 2.31-2.96) were significantly associated with the prevalence of dyslipidemia. Conclusion: The prevalence of dyslipidemia was high among children and adolescents aged 6-17 in 7 provinces in China, 2012. Sugary drinks intake ≥once per week, sedentary time >10 hours per day, overweight and obesity might be the risk factors of dyslipidemia among children and adolescents.

[Association between cesarean birth and the risk of obesity in 6-17 year-olds]

Objective: To explore the association between cesarean section and obesity in child and adolescent. Methods: In this study, a total number of 42 758 primary and middle school students aged between 6 and 17 were selected, using the stratified cluster sampling method in 93 primary and middle schools in Hunan, Ningxia, Tianjin, Chongqing, Liaoning, Shanghai and Guangdong provinces and autonomous regions. Log-Binomial regression model was used to analyze the association between cesarean section and obesity in childhood or adolescent. Results: Mean age of the subjects was (10.5±3.2) years. The overall rate of cesarean section among subjects attending primary or secondary schools was 42.3%, with 55.9% in boys and, 40.6% in girls respectively and with difference statistically significant (P<0.001). The rate on obesity among those that received cesarean section (17.6%) was significantly higher than those who experienced vaginal delivery (10.2%) (P<0.001). Results from the log-binomial regression model showed that cesarean section significantly increased the risk of obesity in child and adolescent (OR=1.72, 95%CI: 1.63-1.82; P<0.001). After adjusting for factors as sex, residential areas (urban or rural), feeding patterns, frequencies of milk-feeding, eating high-energy foods, eating fried foods and the levels of parental education, family income, parental obesity, physical activity levels, gestational age and birth weight etc., the differences were still statistically significant (OR=1.48, 95%CI: 1.39-1.57; P<0.001). Conclusion: The rate of cesarean section among pregnant women in China appeared high which may significantly increase the risk of obesity in child or adolescent.

[Association between polymorphism of rs10185316 in insulin-induced gene 2 and blood pressure among children and adolescents]

Objective: To examine the association between polymorphism of rs10185316 in insulin-induced gene 2 (INSIG2) and blood pressure among children and adolescents. Methods: 9 junior middle schools in Dongcheng District of Beijing and 5 schools (3 primary junior middle schools, 2 primary schools) in Haidian District of Beijing were chosen in 2005 and 2007, respectively. According to the Chinese BMI percentile criteria for screening overweight and obesity in school children, we recruited 1 425 overweight or obese children and 605 normal weight children. A total of 2 018 students with complete data of blood pressure and genotype data were included in this study. According to the blood pressure criterion of children and adolescents, 702 participants were categorized into high blood pressure group and 1 316 into normal blood pressure group. Participants' information of gender, age, height, weight and blood pressure were collected by questionnaire and physical examination. Genomic DNA was extracted from peripheral blood sample for genotyping of INSIG2 rs10185316 polymorphism. Multiple linear regression was conducted to analyze the associations between rs10185316 polymorphism in INSIG2 and SBP, DBP, mean arterial pressure (MAP) and pulse pressure. Results: The age, BMI, SBP and DBP of the high blood pressure group were separately (14.3±1.4) years old, (27.3±4.2) kg/m(2), (130.5±10.9) and (76.7±13.3) mmHg (1 mmHg=0.133 kPa), all higher than that of the normal blood pressure group, which were (12.2±2.9) years old, (22.0±4.0) kg/m(2), (104.4±10.9) and(54.6±15.2) mmHg, respectively (all P values<0.001). After age, sex, district and BMI adjusted, compared with the participants carrying INSIG2 rs10185316 CC genotype, CG/GG genotype carriers had lower DBP (β(95%CI):-1.67(-2.84--0.50), P=0.005), higher PP(β(95%CI): 1.91(0.61-3.20), P=0.004), and lower MAP(β(95%CI):=-1.03(-2.01--0.05), P=0.039). Conclusion: INSIG2 rs10185316 polymorphism was associated with DBP, PP and MAP among children and adolescents in an independent way from BMI.

[Analysis of association between appendicular skeletal muscle mass index and main anthropometric parameters among overweight and obese adults in China]

Objective: To investigate the associations between the appendicular skeletal muscle mass index and main anthropometric parameters, and to provide clues for preventing the reduction of skeletal muscle mass among overweight and obese adults in China. Methods: 1 488 volunteered participants who resided in Beijing longer than one year, between 22 and 55 years old, with self-report BMI ≥24 kg/m(2) were recruited from April to May 2014. 171 participants whose BMI ≤24 kg/m(2) or with organic diseases at the first physical examination were excluded, finally 1 317 overweight/obese participants (male and female were 507, and 810, respectively) were enrolled into the present study. After measuring the anthropometric parameters and body composition by the DXA, Pearson correlation analysis and multiple linear regression models were used to analyze the associations between the appendicular skeletal muscle mass index and main anthropometric parameters. Results: The average age of males and females was (35.6±8.4) and (38.2±9.4) years old, respectively. The females' mean levels of body fat percentage, BMI, waist circumference, hip circumference, and bone mineral density were (41.59±4.14)%, (29.00±3.75) kg/m(2), (92.56±9.00) cm, (101.74±6.75) cm, and (1.20±0.10) g/cm(2), respectively; and the males' mean levels were (34.22±4.61)%, (30.07±4.12) kg/m(2), (99.63±9.49) cm, (102.93±7.28) cm, and (1.28±0.11) g/cm(2), respectively. The mean level of appendicular skeletal muscle mass and skeletal muscle mass index in males were (26.98±3.88), and (8.96±1.02) kg, respectively, which were significantly higher than it in females ((18.57±2.61), and (7.26±0.83) kg, respectively) (P<0.001). For male, the correlation coefficients of skeletal muscle mass index with BMI, waist circumference, hip circumference, body fat percentage and bone mineral density were 0.814, 0.601, 0.637, 0.558, and 0.434, respectively; for female, the correlation coefficients of skeletal muscle mass index with BMI, waist circumference, hip circumference, body fat rate and bone mineral density were 0.761, 0.534, 0.585, 0.610, and 0.304, respectively. The correlations were statistically significant (P<0.001). Multiple linear regression analysis showed that the skeletal muscle mass index of male decreased with the increase of age (β=-0.01, 95%CI:-0.01-0.00) and body fat percentage (β=-0.13, 95%CI:-0.15--0.12) (P<0.05), while increased with the increase of BMI (β=0.31, 95%CI: 0.29-0.32) and bone mineral density (β=0.54, 95%CI: 0.10-1.01) (P<0.05). The skeletal muscle mass index of female decreased with the increase of age (β=-0.01, 95%CI:-0.01-0.00) and body fat percentage (β=-0.12, 95%CI:-0.14--0.12) (P<0.05), while increased with the increase of BMI (β=0.26, 95%CI: 0.25-0.28) and hip circumference (β=0.01, 95%CI: 0.00-0.02) (P<0.05). Conclusion: The skeletal muscle mass index of male was higher than it of female. For male, the skeletal muscle mass index might be associated with age, BMI, body fat percentage and bone mineral density. While for female, the skeletal muscle mass index might be associated with age, BMI, body fat percentage and hip circumference.

Analysis of genetic diversity and population structure of oil palm (Elaeis guineensis) from China and Malaysia based on species-specific simple sequence repeat markers

Genetic diversity and patterns of population structure of the 94 oil palm lines were investigated using species-specific simple sequence repeat (SSR) markers. We designed primers for 63 SSR loci based on their flanking sequences and conducted amplification in 94 oil palm DNA samples. The amplification result showed that a relatively high level of genetic diversity was observed between oil palm individuals according a set of 21 polymorphic microsatellite loci. The observed heterozygosity (Ho) was 0.3683 and 0.4035, with an average of 0.3859. The Ho value was a reliable determinant of the discriminatory power of the SSR primer combinations. The principal component analysis and unweighted pair-group method with arithmetic averaging cluster analysis showed the 94 oil palm lines were grouped into one cluster. These results demonstrated that the oil palm in Hainan Province of China and the germplasm introduced from Malaysia may be from the same source. The SSR protocol was effective and reliable for assessing the genetic diversity of oil palm. Knowledge of the genetic diversity and population structure will be crucial for establishing appropriate management stocks for this species.

Characteristic spectrum of very low-energy photoelectron from above-threshold ionization in the tunneling regime

We report an experimental and theoretical study of very low-energy photoelectrons in tunneling ionization process from noble gas atoms interacting with ultrashort intense infrared laser pulses. A universal peak structure with electron energy well below 1 eV in the photoelectron spectrum, corresponding to the double-hump structure in the longitudinal momentum distribution, is identified experimentally for all atomic species. Our quantum and semiclassical analysis reveal the role of long-range Coulomb potential in the production of this very low-energy peak structure.

Functional intracellular P-glycoprotein

Efflux of chemotherapy drugs by P-glycoprotein (P-gp) at the plasma membrane is thought to be a major cause of cancer multidrug resistance. In this report, we show by flow cytometry that P-gp also concentrates large amounts of 2 different drugs, Hoechst 33342 and daunorubicin, within a cytoplasmic compartment of multidrug resistant CHRC5 cells. A quantitative assay of Hoechst 33342 revealed that cytoplasmic sequestration by P-gp in CHRC5 cells accounted for about half of the amount of Hoechst 33342 accumulated by the drug-sensitive parental Aux BI cells. Daunorubicin sequestered in the cytoplasm of CHRC5 cells could be released by inhibiting P-gp function with cyclosporin A, resulting in cell death. A likely site of drug sequestration is P-gp-containing cytoplasmic vesicles, in which the P-gp is oriented so that drugs are transported and concentrated in the interior of the vesicles. P-gp was detected in the membranes of cytoplasmic vesicles of CHRC5 cells by confocal immunofluorescence microscopy and immunoelectron microscopy with anti-P-gp monoclonal antibodies (MAbs). Vesicular localization of daunorubicin was observed by epifluorescence microscopy. The origin and nature of the P-gp-containing vesicles are unknown, but they do not correspond to endocytic vesicles. Our results directly demonstrate that chemosensitizer-induced release of drugs sequestered in cytoplasmic vesicles by P-gp can be used to overcome multidrug resistance.

Simultaneous determination of creatine, uric acid, creatinine and hippuric acid in urine by high performance liquid chromatography

A simple method for the simultaneous determination of creatine, uric acid, creatinine and hippuric acid in urine using reversed-phase high performance liquid chromatography was described. Chromatography was performed on a Nova-Pak C18 (3.9 x 150 mm) column with a mobile phase of 0.02 mol/L KH2PO4, and UV detection at 220 nm. The recoveries of creatine, uric acid, creatinine and hippuric acid were 103.13, 99.86, 98.26 and 98.24%, respectively. The calibration curves were linear within the concentration range of 2-200 micrograms/mL for creatine, uric acid and hippuric acid, and 2-400 micrograms/mL for creatinine. The detection limits of the method were 0.69, 0.21, 0.10 and 0.095 microgram/mL for creatine, uric acid, creatinine and hippuric acid, respectively. This method has been applied to the analysis of urine samples from normal subjects and some patients.

[Influence of anterior occlusal contacts of complete dentures on mastication]

The photocclusion and mastication analysis of the complete dentures with or without the anterior occlusal contacts were made. The results indicated that there was no obvious differences among the maximum occlusal contact intensities of each tooth position in central occlusion. Under the functional condition the activity of the anterior temporal muscles was influenced and the mastication efficiency was decreased by the relatively stronger anterior occlusal contacts.

v-mos proteins encoded by myeloproliferative sarcoma virus and its ts159 mutant

The myeloproliferative sarcoma virus (MPSV) v-mos protein was predicted to be identical in size to p39c-mos because of an observed one-base deletion in the seventh codon of the env-mos open reading frame, which would allow translation to initiate at the methionine equivalent to codon 32 of the env-mos gene. On the basis of published results, p39c-mos is known to have greatly reduced in vitro protein kinase activity compared with p37env-mos encoded by Moloney murine sarcoma virus. Unexpectedly, the relative activity of the MPSV v-mos protein kinase was comparable to that of p37env-mos. Consistent with this finding, the size of MPSV v-mos protein was found to be similar to the size of p37env-mos. Moreover, the pattern and sizes of phosphorylated bands produced by autophosphorylation of the MPSV v-mos protein were similar to those of p37env-mos. These results were confirmed by in vitro transcription-translation of the MPSV v-mos gene. Resequencing portions of the MPSV mos gene failed to show the deletion within codon 7. Except for the codon 262 deletion, other mutations characteristic of MPSV and temperature-sensitive MPSV v-mos genes were confirmed. A glycine-to-arginine mutation at residue 338 of the MPSV env-mos sequence, previously shown to cause thermosensitivity of the mutant virus (termed ts159) transforming function, yielded a v-mos protein that had significantly reduced protein kinase activity in vitro. These findings indicate that MPSV, like other Moloney murine sarcoma virus strains, also encodes a functional env-mos protein.

[The antinociceptive effect of intrathecal somatostatin in monkeys]

The distribution of somatostatin (SST) throughout the nervous system suggests that this tetradecapeptide may play a physiological role in CNS in the mediation of analgesia. The present study was undertaken to evaluate the antinociceptive properties of intrathecal (IT) injection of SST in the comparison of morphine sulfate (MS) in a primate model. The study was conducted after institutional approval and adhered to the regulations of the animal research committee. Seven adult monkeys (Maccaca cyclopis Swinhoe) weighing 4-6 kg were used. In each animal a L5 laminectomy window was created to facilitate IT injection. No neurological damage from surgery was noted. With the monkey standing in a specially constructed cage, all animals randomly received the following agents at one-week interval: (1) MS 1 mg, IT; (2) SST 50 micrograms, IT; (3) SST 250 micrograms, IT; and (4) SST 250 micrograms, IT + intramuscular (IM) naloxone 400 micrograms. The measured withdrawal latency (HPWL) was converted to the maximal percentage effect (MPE %) for comparison. The HPWL was measured at predrug and 5, 15, 30, 45, 60, 90 and 120 min after injection. Venous blood sample was obtained every 15 min to determine the plasma SST level by radioimmunoassay (RIA) technique in group 3 only. The results showed that MS (1 mg, IT) produced potent antinociception (MPE 100%) for more than 2 h. Intrathecal SST 50 micrograms, however, induced mild antinociception (MPE 43%) for only a short period and a 5-fold larger dose (250 micrograms) did not significantly change the nociceptive threshold with MPE only up to 47%.(ABSTRACT TRUNCATED AT 250 WORDS)

On the coexistence of stereopsis and binocular rivalry

Dichoptically viewed complex texture stereograms with correlated spatial frequency information can yield stable depth perception, implying cooperative interaction between the two eyes. Dichoptically viewed dissimilar texture pairs may yield competition in the form of binocular rivalry. To study whether stereopsis and rivalry can spatially coexist when stimulus conditions for both are present, we had observers dichoptically view spatial frequency filtered random-dot patterns. The left eye viewed one half-image of an RDS; the right eye viewed the superimposition of the other RDS half-image (which when paired alone with the left-eye RDS yielded stereoscopic depth) and a noise target (which on its own engaged in rivalry with the right eye target). Observers judged the quality of depth and the rate of rivalry for these stereo-pairs. When the contrast of the noise component was low, observers experienced stereopsis and stable single vision that included the noise. At intermediate noise contrasts, local regions were seen either in rivalry or in stereoscopic depth, but rivalry and depth were not experienced at the same spatial location simultaneously. At high noise contrasts, the right eye target dominated almost exclusively, with little hint of stereopsis. Essentially the same pattern of results was obtained in forced-choice experiments in which observers judged the direction of stereoscopic tilt from vertical cosine gratings differing slightly in spatial frequency. Considered together, these results are inconsistent with theories positing that rivalry and stereopsis coexist at the same spatial location because they occur within independent, parallel pathways.

Early detection of cerebral dysfunction by quantitative EEG during cardiopulmonary-bypass period for open-heart surgery

Neuropsychiatric complications are well known risks of open heart surgery. In this regard cerebral damage is caused either by microembolism or insult from low perfusion pressure as a consequence of extracorporeal circulation. It seems probable that monitoring of the quantitative electroencephalography (QEEG) during the surgical procedure can help minimize the incidence of neurological sequelae through early detection. Moreover, it seems important to establish whether the pre-operative EEG has a predictive value for the possible neurological outcome and whether the post-operative EEG has conclusive value for the neurological outcome and, above all to ascertain whether the peri-operative QEEG contains information valuable on the diagnosis of final neurological outcome. To elucidate the feasibility of QEEG as a means to monitor the cerebral function a study was thus undertaken. Twenty-five ASA II-IV patients with age ranging from 25-79 y/o undergoing cardiac surgery under extracorporeal circulation were enrolled for study. The types of surgery varied from coronary artery by-pass graft (CABG), valvular replacement, and excision and grafting for aortic dissecting aneurysm. 16-channel EEGs were recorded with a Cadwell Spectrum 32 in accordance with the international 10-20 system. 48 epochs (1 epoch = 2.5 seconds) of EEG recordings of pre-bypass and post-bypass periods were measured and quantitatively analyzed. Pre- & post-operatively, psychoneurological assessments were performed and correlated with the QEEG. The parameters employed in the study were absolute power, relative power, power asymmetry, and coherence. All the results of two-session comparisons were transformed into z score values. Our preliminary study revealed that there exists a specific multivariate profile of QEEG for specific disease entity. And all the patients with z score less than or equal to 3.0 turned out to be free from any significant sequelate.

[Continuous thoracic epidural fentanyl in postoperative pain control--a comparison of two different dosages]

We evaluate the postoperative pain relief using continuous epidural fentanyl infusion in two different dosages for thoracic and upper abdominal surgeries. A total of 21 ASA class III patients were studied. A thoracic epidural catheter was placed before surgery but pain control was begun when the patients became fully awake and complained of pain in the recovery room. Patients were divided into group A (n = 9) and group B (n = 12). Those in group A were given fentanyl 1.5 micrograms/kg in saline solution as initial dose followed by continuous infusion at a rate of 1 microgram/kg/h for 23 hours. In group B the initial dose and the maintenance dose were respectively 1.0 microgram/kg and 0.5 micrograms/kg/h. Following the initial dose, the intensity of pain was assessed hourly for a total of 24 hours using a visual analogue pain scale with scores from 0 to 10. In group A, the pain scale fell from the baseline level of 7.7 +/- 2.6 to 2.3 +/- 2.0 at the first hour while in group B it fell from 8.9 +/- 1.4 to 4.3 +/- 2.1. The pain scores following continuous infusion in groups A and B were respectively 1.3 +/- 1.5 and 2.9 +/- 1.7. Although the analgesic effect appeared to be better in group A, pain relief was satisfactory in both groups (p less than 0.01). Regarding respiratory depression, there was a greater degree of rise in PaCO2 in group A and some of the patients even had a PaCO2 value above 50 mmHg.(ABSTRACT TRUNCATED AT 250 WORDS)