[Imaging study on thoracic and lumbar physiological curvature in adolescent idiopathic scoliosis]

OBJECTIVE

To observe the alteration of thoracic and lumbar physiological curvature in adolescent idiopathic scoliosis(AIS) and the difference of physiological curvature between different types of scoliosis.

METHODS

A retrospective analysis was conducted on 305 adolescent patients taken full spine X-ray in our hospital from January 2017 to December 2021. The patients were divided into normal group and scoliosis group. The normal group was composed of 179 patients, 79 males and 100 females, aged 10 to 18 years old with an average of (12.84±2.10) years old, with cobb agle less than 10 degrees. The scoliosis group was composed of 126 patients, 33 males and 93 females, aged 10 to 18 years old with an average of (13.92±2.20) years old. The gender, age, Risser sign, thoracic kyphosis(TK) and lumbar lordosis(LL) in 2 groups were compared, and the TK and LL were also compared between different genders, different degrees of scoliosis and different segments of scoliosis.

RESULTS

The female ratio(P=0.001) and age (P<0.001) in scoliosis group were higher than them in normal group; the ratio of low-grade ossification was higher in normal group than in scoliosis group(P=0.038). TK was significantly smaller in scoliosis group than in normal group(P<0.001), but there was no significant difference in LL between the 2 groups(P=0.147). There were no significant difference in TK and LL between male and female. The TK was significantly bigger in mild AIS patients than in moderate AIS patients(P<0.05), but there was no significant difference in LL between mild and moderate patients(P>0.05). The TK and LL in different segments scoliosis were not found significant difference.

CONCLUSION

The physiological curvature of thoracic and lumbar spine is independent of gender. The thoracic physiological curvature becomes smaller in AIS patients, but lumbar curvature remains unchanged. The thoracic physiological curvature in mild AIS patients is greater than that in moderate AIS patients, but the lumbar curvature is almost unchanged between mild and moderate scoliosis and is similar with that in normal adolescent. The alteration of thoracic and lumbar physiological curvature in AIS patients may be related to relative anterior spinal overgrowth, and the specific detailed mechanism needs to be further studied.

[Correlation analysis of Cobb angle and linear spinous process angle in adolescent idiopathic scoliosis]

OBJECTIVE

To analyze the correlation between Cobb angle and spinous process angle (SPA) on X-ray film and body surface in patients with mild to moderate adolescent idiopathic scoliosis(AIS). To explore the possibility of linear SPA to assess scoliosis.

METHODS

Retrospective study for correlation of Cobb angle and linear SPA on X-ray film. AIS patients treated and taken full spine anteroposterior X-ray from January 2019 to December 2021 were analyzed correlation of Cobb angle and linear SPA on X-ray film. Prospective study for correlation of Cobb angle and body linear SPA. AIS patients treated and taken full spine anteroposterior X-ray from December 1 to December 9 this year were analyzed correlation of Cobb angle and body linear SPA.

RESULTS

A total of 113 AIS patients with age an average of (14.02±2.16) years old(ranged from 10 to 18 years old) were recruited in retrospective study, involving 26 males and 87 females;there were 71 patients with mild AIS and 42 patients with moderate AIS. Cobb angle in AIS patients was significantly inversely associated with SPA(r=-0.564, P<0.001), the linear regression equation was:Cobb angle=169.444-0.878×SPA. Cobb angles in patients with mild scoliosis were significantly and inversely associated with SPA(r=-0.269, P=0.012), the linear regression equation was:Cobb angle=46.832-0.185×SPA. Cobb angles in patients with moderate scoliosis were also clearly correlated with SPA(r=-0.417, P=0.003), the linear regression equation was:Cobb angle=113.889-0.516×SPA. Thirty-eight patients were recruited in prospective study. The mean Cobb angle and body linear SPA were(18.70±6.98)°, ranged from 11.3° to 36.0° and (170.34±4.57)°, ranged from 162.1° to 177.7° respectively. There was significantly negative correlation(r=-0.651, P<0.001), the linear regression equation is:Cobb angle=187.91-0.99×SPA.

CONCLUSION

Linear SPA on X-ray film or on the body was significantly negatively correlated with Cobb angles, but the regression equation fits poorly, so it's not suitable for diagnosis of scoliosis;however, linear SPA is appropriate for self-controlled assessment of scoliotic therapy or for dynamic assessment of spinal flexibility.

[The association between stress hyperglycemia ratio and outcome of patients with acute ischemic stroke undergoing endovascular treatment]

Objectives: To investigate the correlation between stress hyperglycemia ratio (SHR) and outcomes in patients with acute ischemic stroke treated with endovascular treatment. Methods: In a multicenter registration study for RESCUE-RE (a registration study for critical care of acute ischemic stroke after recanalization), eligible patients with large vessel occlusion stroke within 24 hours after onset who received endovascular treatment between July 2018 and May 2019 were enrolled. SHR was calculated as the fasting glucose concentration divided by the estimated average glucose concentration and then categorized into four groups according to the quartiles (group Q₁, group Q₂, group Q₃ and group Q₄). The primary outcome was poor neurological outcomeat day 90 fromstroke onset [defined as modified Rankin scale (mRS) of 3-6]. Secondary outcomes included early neurological deterioration (END), death within 3 months after stroke onset, and symptomatic intracranial hemorrhage.Multivariable logistic and Cox regression modelswere used to assess the correlation between quartiles of SHR and prognosis in patients with endovascular treatment. Results: A total of 592 patients were enrolled in the study, with a mean age of (63±12) years, and 68.07% were male.The median National Institute of Health stroke scale(NIHSS) score on admission was15(11, 20), and the median SHR was 1.23 (1.07, 1.47), with SHR<1.07 in group Q₁, 1.07≤SHR<1.23 in group Q₂, 1.23≤SHR<1.47 in group Q₃ and SHR≥1.47 in group Q₄, respectively. The rate of complete recanalization was lower in group Q₄ than that of group Q₁ (70.27% vs 83.67%, P=0.026). After fully adjusted for potential covariates, the risk of poor neurological outcome at day 90 from stroke onset in group Q₄ was 2.38 folds that of group Q₁(adjusted OR= 2.38, 95%CI: 1.57-3.57,P=0.003). The risk of death within 3 months of patients in group Q₄ was 1.80 times that of the patients in group Q₁, but the difference was not statistically significant(adjusted HR=1.80, 95%CI: 0.90-3.62, P=0.098). Conclusion: Higher SHR was correlated with poor neurological outcome at 3 months in large artery occlusion related acute ischemic stroke patients receiving endovascular therapy.

[Clinical analysis of 554 patients with colorectal diverticulosis]

Objective: Most patients with asymptomatic colorectal diverticulosis are easily overlooked. However, some of diverticulosis become diverticulitis, bleeding and even perforation, which cause extensive harm to patients. The purpose of this study is to analyze the incidence, clinical features, diagnosis and treatment of colorectal diverticulosis in order to improve the clinical understanding of diverticulosis and its related complications. Methods: A descriptive cohort study was carried out. Clinical data of 554 patients with colorectal diverticulosis confirmed by CT, colonoscopy, digestive tract radiography or operation in Peking University First Hospital from January 2009 to June 2019 were retrospectively analyzed. Patients with malignant tumors, autoimmune diseases, long term use of immunosuppressive drugs, chronic liver diseases and renal diseases, and mental disorders were excluded. The analysis parameters included gender, onset age, clinical symptoms, location of diverticulitis, treatment and prognosis. According to the criteria established by the World Society of Emergency Surgery (WSES), acute diverticulitis was divided into 5 stages based on the extension of the infectious process. Stage 0 was simple diverticulitis and stage 1-4 was complicated diverticulitis. Results: Among the 554 patients with colorectal diverticulosis, 358 (64.6%) were males, the median onset age was 63 years; 191 patients (34.5%) had various digestive symptoms, of whom 113 (20.4%) had chronic constipation and abdominal distension, 78 (14.1%) had chronic diarrhea and abdominal pain; the other 363 patients had no obvious abdominal symptoms. Four hundred and six patients were found by colonoscopy and 465 patients were found by CT. Twenty-five patients were diagnosed by lower gastrointestinal tract radiography and 3 were confirmed during operation. There were 339 patients with multiple diverticula (61.2%) and 215 patients with single diverticulum (38.8%). 76.5% (424/554) of diverticula were located in colon, 37.0% (205/554) in ascending colon, 21.3% (118/554) in multiple sites, and 2.2% (12/554) in rectum. The median diameter of diverticulum was 7 mm, and 78 cases (14.1%) was ≥30 mm. Forty-nine patients (8.8%) developed acute diverticulitis, including 13 patients with simple diverticulitis and 36 patients with complicated diverticulitis. Among 36 patients with complicated diverticulitis, 29 (80.6%) were males, 27 (75.0%) had recurrent abdominal pain and fever before onset; diverticula of 25 cases were located in sigmoid colon; 11 cases in ascending colon. Nine cases developed sigmoid colon perforation and 8 cases developed vesicocolonic fistula, and these 17 patients underwent surgical treatment. The other 19 cases with complicated diverticulitis developed gastrointestinal bleeding, of whom 18 cases were male, 11 cases were located in ascending colon; 13 cases were healed after conservative treatment, 4 cases received endoscopic hemostatic intervention, and 2 cases underwent surgery. Conclusions: Colorectal diverticulosis is more common in male patients, and CT and colonoscopy are main diagnostic methods. The symptoms of complicated colonic diverticulitis are related to the location of diverticulum. In addition to symptomatic treatment, surgical procedures are the most important treatments.

[Analysis on risk factors of the degree of radical resection and prognosis of patients with locally recurrent rectal cancer]

Objective: To evaluate the factors affecting the degree of radical resection and the prognosis of patients with locally recurrent rectal cancer (LRRC). Methods: A retrospective case-control study was performed. Clinical data of 111 patients with LRRC undergoing operation at the General Surgery Department of Peking University First Hospital from January 2009 to August 2019 were analyzed retrospectively. The "Peking University First Hospital F typing" was performed according to the preoperative images of the pelvic involvement. The pelvis was assigned into four directions: the front wall, lateral sides of the pelvic wall and the sacrum. According to the degree of pelvic wall involvement, F typing included F0 type (no involvement of the pelvic wall, the cancer only involved the adjacent organs or invaded conteriorly the urinary tract, genital organs or small intestine), F1 type (cancer involved the pelvic wall in one direction, such as the sacrum, or one side of the pelvic wall), F2 type (cancer involved the pelvic wall in two directions) and F3 type (cancer involved the pelvic wall in three directions). Case inclusion criteria: (1) LRRC was confirmed by imaging and pathological examination of samples (puncture or endoscopic biopsy); (2) complete clinical and follow-up data; (3) informed consent of patient. Those with dysfunction of heart, lung, etc., intolerance of operation, F3 type indicated by image, and distant metastasis were excluded. The degree of radical resection was evaluated according to the postoperative pathological results. Patients were followed up every 12 months and related examinations were arranged. The univariate analysis of radical resection was performed by χ(2) test, and the multivariate analysis was performed by logistic methods. The survival rate was calculated by Kaplan-Meier method and the survival curve was drawn. The survival rate was compared by log-rank test. Cox proportional hazards model was used to analyze the factors affecting the prognosis of patients with LRRC. Results: A total of 111 patients were included in this study. Of 111 patients, 59 were male and 52 were female; recurrent age of 36 cases was ≥ 65 years old; CEA level of 48 cases was ≥15 μg/L. According to the "Peking University First Hospital F typing", 70 cases were F0 type, 38 F1 type and 3 F2 type. Surgical procedures were abdominoperineal resection (n=28), posterior pelvic exenteration (n=32), and total pelvic exenteration (n=51, including 1 case of TPE combined with sacrectomy). According to the postoperative pathological results, R0, R1 and R2 resections were 83, 20 and 8 cases, respectively. Univariate analysis showed that the degree of radical resection was associated with the secondary surgical procedure, F typing and lymph node metastasis (all P<0.05). Multivariate analysis showed that F typing (F1-F2) was an independent risk factor for non- R0 resection (OR=37.256, 95%CI:8.572 to 161.912, P<0.001). The morbidity of operative complications was 22.5% (25/111); the perioperative mortality was 1.8% (2/111); the local recurrence rate after the second operation was 37.8% (42/111). The 3- and 5-year overall survival rates were 41.2% and 21.9% respectively. The 3-year survival rates of patients with and without postoperative chemotherapy were 52.7% and 32.4% respectively (P=0.005). The 3-year survival rates of patients with lower (<15 μg/L) and higher CEA level (≥15 μg/L) were 52.9% and 24.3% respectively (P<0.001). The 3-year survival rates of patients with R0, R1 and R2 resection were 49.8%, 21.3% and 8.5% respectively (P=0.002). The 3-year survival rates of patients with F0, F1 and F2 type were 52.7%, 22.0% and 0 respectively (P<0.001). Cox analysis confirmed that the degree of radical resection (HR=2.088, 95%CI:1.095 to 3.979, P=0.025), the CEA level before the secondary operation (HR=1.857, 95%CI:1.157 to 2.980, P=0.010) and postoperative chemotherapy (HR=1.826, 95%CI:1.137 to 2.934, P=0.013) were independent factors affecting the prognosis. Conclusions: The indication of LRRC surgical treatments must be strictly limited. Evaluation of the fixation site to the pelvic wall is helpful for improving the rate of R0 resection. Lower preoperative CEA level, radical resection and postoperative chemotherapy are protective factors of prolonged overall survival time of patients with LRRC.

[Preoperative evaluation using multi-slice spiral CT angiography of right-side colon vascular in laparoscopic radical operation for right colon cancer]

Objectives: To examine the value of multi-slice spiral CT angiography (MSCTA) in the analysis of anatomical variation and structural classification of right colon vessels. Methods: From August 2015 to August 2017, 198 patients (96 of whom underwent laparoscopic radical resection of right colon cancer) at Department of General surgery of Peking University First Hospital were retrospectively collected, and the results of abdominal enhanced CT scan were collected and three-dimensional reconstruction of blood vessels was performed. There were 104 males and 94 females. The age was 64(27) years (M(Q(R)), range: 19 to 87 years). Right gastroepiploic vein, anterior superior pancreaticoduodenal vein, right colonic vein (RCV), superior right colonic vein, ileocolon artery or vein (ICA or ICV), middle colon artery or vein (MCA or MCV) and Henle trunk were observed and recorded respectively. The anatomical relationship between the positions of blood vessels, the length of Henle trunk and surgical trunk were measured. Results: ICV and ICA were the most constant anatomic structures. The ICV/ICA of all patients came directly from SMV/SMA, 36.9% (73/198) ICV going in front of SMV and 63.1% (125/198) behind SMV. 72.2% (143/198) of the patients had RCV imported into Henle trunk and the rest into SMV. Middle colonic vein (MCV) could be observed in 81.3% (161/198) of the cases. 81.4% (131/161) of MCV were imported into SMV, 16.8% (27/161) into Henle trunk, 1.2% (2/161) into the first jejunal vein and 0.6% (1/161) into the splenic vein. Henle trunk was divided into 4 types, among which the occurrence probability of gastric node and pancreatic trunk was the highest. The dry length of Henle trunk was (0.82±0.39) cm (range: 0.37 to 1.68 cm). The length of surgical trunk was (2.54±0.83) cm (range: 1.57 to 3.95 cm). Accuracy of MSCTA results was 96.9%(93/96). Conclusions: Anatomical variation of blood vessels in the right colon is common. Abdominal CT angiography can accurately determine the anatomical structure of the blood vessels in the right colon.

[Inhibitory effect of DAPT on Notch signaling pathway in curcumin mediated photodynamic therapy for cervical cancer xenografts in nude mice]

Objective: Curcumin was used as photosensitizers in photodynamic therapy on cervical cancer xenografts in nude mice.Analysis the expression changes of Notch and downstream gene as NF-κB and VEGF before and after DAPT inhibition of Notch signaling pathway in vivo experiments.Our aim was to investigate the possible mechanism of Notch signaling pathway in the treatment of cervical cancer with PDT. Methods: A cervical cancer model of nude mice was established by subcutaneous inoculation of human cervical cancer Me180 cells 200 μl.After the success of the model, the experimental animals were divided into 4 groups (model group, curcumin PDT group, simple DAPT group, curcumin-PDT+ DAPT group), each group was 12.Tumor volume changes were analyzed and HE staining was observed in each group.MRNA and protein expression of Notch1 and its downstream NF-κB, VEGF were detected by RT-PCR, immunohistochemistry and Western blot before and after inhibition of Notch signaling pathway by DAPT. Results: Except the control group, the tumor volume of the other three groups remained unchanged or slightly reduced after 1-7 days of treatment.The difference was significant (P<0.05). HE staining showed the most obvious necrosis of curcumin-PDT group with DAPT.Both DAPT and curcumin-PDT could reduce the expression level of Notch1 in mRNA.The inhibition rates were 42.17% and 40.54%, respectively.And the inhibitory effect of curcumin-PDT with DAPT on Notch-1 was the strongest (79.22%) (P<0.01), and two of them had synergistic effect after combination with curcumin-PDT.But the expression of Notch-2 has no obvious inhibitory effect (P>0.05). Both DAPT and curcumin-PDT can inhibit the protein expression of Notch1, NF-κB and VEGF, and two of them have synergistic effect after combined use. Conclusions: DAPT can effectively block the Notch signaling pathway and inhibit the proliferation of cervical cancer cell line Me180.The application of DAPT to inhibit Notch signaling pathway after photodynamic therapy can achieve synergistic effect, which is mainly related to the down-regulation of the expression of Notch1 and NF-κB.Notch signaling pathway may be one of the targets of curcumin-PDT photodynamic therapy.

[Difference of one year death and stroke recurrence in ischemic stroke patients with anterior and posterior circulation intracranial atherosclerosis]

Objective: To explore the differences of one year death and stroke recurrence between ischemic stroke patients with intracranial atherosclerotic stenosis or occlusion of anterior circulation and those of posterior circulation. Methods: All the patients were from the Chinese Intracranial Atherosclerosis Study (CICAS), between October 2007 and June 2009; patients with extracranial stenosis or occlusion, patients without acute infarction by diffusion weighted image, and patients with intracranial atherosclerosis of both anterior and posterior circulation were excluded.All the enrolled patients were divided into three groups: no significant intracranial atherosclerosis group (n=964), anterior circulation intracranial atherosclerosis group (n=440), posterior circulation intracranial atherosclerosis group (n=233). One year outcome was evaluated by any cause of death and stroke recurrence. Results: Of the 1 637 patients, 30 cases were died and 58 cases had stroke recurrence within one year.Compared with : no significant intracranial atherosclerosis group, adjusted hazard ratio (95% confidence interval) of one-year death for anterior and posterior circulation intracranial atherosclerosis group were 1.349 (0.311-5.851), 4.542 (1.227-16.813), respectively.Adjusted hazard ratio (95% confidence interval) of one year stroke recurrence were 1.663 (0.620-4.460) and 2.464 (0.935-6.493), respectively. Conclusions: Ischemic stroke patients with intracranial atherosclerosis of posterior circulation has higher risk of one year death. One year stroke recurrence risk for patients with intracranial atherosclerosis of anterior and posterior circulation needs to be further evaluated.

Genetic variations in the active efflux pump genes acrA/B and tolC in different drug-induced strains of Escherichia coli CVCC 1547

This study aimed to investigate the properties of mutations of the active efflux pump genes acrA/B and tolC in Escherichia coli CVCC 1547 when induced by different drugs. The mutations were isolated in vitro by exposing E. coli CVCC 1547 to stepwise increases in the concentration of ceftriaxone (CRO), amikacin (AMK), or ciprofloxacin. The results showed that the minimum inhibitory concentrations for the corresponding drugs increased, as did the minimum inhibitory concentrations for other fluoroquinolones and β-lactam drugs that were not inducers. DNA sequence analyses of the acrA/B and tolC genes of the mutants and comparison with the parent strain revealed that genetic variations had occurred. Three point mutations resulted in amino acid changes in the proteins expressed. Specifically, strain CRO10 had a mutation in acrA, A309G, that resulted in a Thr-103 to Ala substitution, and a mutation in tolC, G735A, that changed Ala-245 to Thr; strain AMK20 (and AMK30) had a Val-447 to Ile amino acid change in acrB. In addition to the missense mutations in these strains, we detected 7, 20, and 15 nonsense mutations in acrA, acrB, and tolC, respectively. To sum up, multiple genetic sequence variations and some changes in amino acid sequences were detected when E. coli CVCC 1547 was challenged in vitro with CRO, AMK, or ciprofloxacin. These changes may have given rise to multidrug-resistant strains.

Managerial attitudes on the development of health promoting hospitals in Beijing

In 2002, the Beijing Committee for Disease Prevention launched guidelines based on the Ottawa Charter for Health Promotion on health promoting hospitals (HPHs). HPH pilot projects were then initiated, on a voluntary basis, in 44 Beijing hospitals. Evaluations have been undertaken to assess the impacts of the pilot project. This article outlines this HPH project, its development and evaluation and reports on the attitudes and contribution of hospital management as determined by questionnaires and interviews from 281 managerial employees from 106 Beijing hospitals (93 from pilot hospitals and 188 from control). The results of the evaluation indicate that long-term health promotion planning and health promotion specialized funds have been better established in pilot hospitals than in the control group and also that the concept of HPH is better understood by managerial staff in pilot hospitals than by those in control hospitals. The main perceived barriers faced in the development of HPH are shortages of funds, personnel, time management and professional skills. To further develop HPHs in China, effort needs to be made to ensure that hospital leaders and management are considered first. If managerial staff have an appropriate understanding of the concept and principles of HPH, then it is more likely that health promotion activities can be introduced into the daily workings of hospitals, and the necessary funds, personnel and training on health promotion skills be provided.

Homeobox genes and their functions on development and neoplasm in gastrointestinal tract

AIM

To describe the role of homeobox genes on development and tumorigenesis in gastrointestinal tract.

METHODS AND RESULTS

We searched the MEDLINE database (until March, 2006) with the keywords of homeobox genes, gastrointestinal tract, development, tumorigenesis, carcinogenesis and therapeutic targets. We reviewed the literature on classification of homeobox genes, development of gastrointestinal tract, carcinogenesis of gastrointestinal tract as well as therapeutic targets.

CONCLUSIONS

The functional effects of homeobox family in development and tumorigenesis of gastrointestinal tract are identified. The importance of homeobox genes and a possibility of therapeutic intervention in clinical medicine are discussed.

Nosocomial Exophiala jeanselmei pseudoinfection after sonography-guided aspiration of thoracic lesions

BACKGROUND AND PURPOSE

During the period from August 1994 to October 1998, a total of 19 isolates of Exophiala jeanselmei were recovered from 17 patients with various underlying thoracic diseases treated at National Taiwan University Hospital. The purpose of this study was to describe the clinical characteristics of these patients and to determine the microbiologic relatedness of the E. jeanselmei.

METHODS

Of the 19 isolates, 11 from nine patients were preserved and were identified based on their biotypes as determined by the API ID32C System, their cellular fatty acid profiles by gas-liquid chromatography, their antibiotypes to five antifungal agents by the E-test, and their random amplified polymorphic DNA (RAPD) patterns by arbitrarily primed PCR. Extensive environmental surveillance cultures and cultures from the skin of eight patients and hands of one physician were also performed.

RESULTS

One of the 17 patients had E. jeanselmei isolated from cutaneous phaeohyphomycosis (3 isolates), and the other 16 patients had isolations from pleural effusion specimens (15 isolates) or lung mass (1 isolate) following sonography-guided aspiration. The latter 16 patients had no clinical or pathologic evidence of fungal infection. Isolates (clone 1) from aspirated specimens had identical biotypes, antibiotypes, and RAPD patterns, which were different from those of the three isolates (clone 2) from the patient with a cutaneous lesion. All specimens from environmental sources, patients' skin, and the hands of the physician were negative for E. jeanselmei.

CONCLUSION

This series of patients demonstrates the difficulty in identifying the sources of a nosocomial pseudoinfection due to this slow-growing microorganism when isolated from pleural effusion specimens.

Clinical features and in vitro susceptibilities of two varieties of Cryptococcus neoformans in Taiwan

One hundred years after introduction of the Eucalyptus tree to Taiwan, a predominantly subtropical island, we analyzed clinical and microbiological data of 59 patients with Cryptococcus neoformans infection hospitalized at National Taiwan University Hospital during 1982 to 1997. There were 38 (64.4%) cases of cryptococcosis caused by the var. neoformans and 21 (35.6%) caused by the var. gattii. Thirty-three patients (55.9%) had impaired T cell function, which included 12 patients with acquired immunodeficiency syndrome (AIDS). Eleven of the 12 patients with AIDS were diagnosed after 1995, and 11 cases were caused by var. neoformans. Minimum inhibitory concentrations (MICs) determined by the NCCLS broth microdilution method using antibiotic medium 3 improved the discrimination of in vitro susceptibility against amphotericin B and demonstrated that var. gattii isolates were less susceptible (geometric means 0.25 microg/ml versus 0.64 microg/ml, P < 0.001). In addition, a higher proportion of var. gattii were less susceptible to flucytosine as compared with var. neoformans (35.0% versus 64.9%, P = 0.030). There was no seasonal clustering for isolation of var. neoformans, though infections caused by var. gattii peaked in July and August. Compared with the first study of cryptococcosis (1957-1972) at NTUH, this study demonstrated the increase in immunocompromised and elderly patients, as well as a higher proportion of Cryptococcus isolated from blood or bone marrow. Facing the increasing adaptive plantation of Eucalyptus in Taiwan, the importance of field study regarding the role of Eucalyptus plantations in Taiwan and occurrence of cryptococcosis in human beings cannot be over-emphasized.

Solitary ileal lipoma presenting with ileocolic intussusception: an unusual cause of enteritis cystica profunda

We report a 63-year-old man who presented with a history of intermittent vague abdominal pain, diarrhea, and weight loss. Colonofibroscopic examination disclosed an ileocolic intussusception with a polypoid tumor on the leading edge of the intussusception. Both double contrast barium enema and computerized tomography of the abdomen confirmed this finding. The excised specimen had an ulcerated ileal lipoma with enteritis cystica profunda on the overlying epithelium.

Evaluation of a rosette inhibition test for pregnancy diagnosis in pigs

A rosette inhibition test was developed using pig lymphocytes and sheep red blood cells. Antilymphocyte serum (ALS) in the presence of complement inhibited rosette formation by greater than 95% at 1/250 declining to no inhibition at 1/8000. Sera obtained from a total of 14 pregnant sows before and 1, 2, 3 and 4 wk after mating were tested for their ability to augment the rosette depression caused by ALS. In one experiment in which the responses of 4 pregnant sows were compared to 4 non-pregnant sows by discriminant analysis, sera were classified correctly in 83% of the samples taken from either pregnant or non-pregnant sows. When the more usual method of calculating the rosette inhibition titre was used, the responses of sera from pregnant pigs were classified with 31% accuracy and those from non-pregnant pigs with 80% accuracy. In a second experiment, sera from 10 pregnant sows were classified with 25% accuracy using the rosette inhibition titre. Thus 4 of these pigs were classified as non-pregnant by this method. Data from the second experiment were not suitable for discriminant analysis. It was concluded that there was some factor present in the sera of pregnant pigs, particularly by 3 or 4 wk post-mating, which could be detected by the rosette inhibition test. However, the test is not sensitive enough to allow specific diagnosis of early pregnancy in pigs.

Effect of lipid solvents on cutaneous moisture loss

Application of various lipid solvents and dimethyl sulphoxide to the skin of cattle, sheep, eland and African buffalo exposed to an air temperature of 20 degrees C caused an increase in cutaneous moisture loss. The effect did not occur after exposure to an air temperature of 40 degrees C or after adrenaline administration. Blockage of sweating by either bethanidine or phenoxybenzamine did not affect the response. Camel, donkey, dog and man showed no increase in cutaneous moisture loss after lipid solvent application to the skin. It is concluded that lipid solvents directly stimulate the secretory cells of the sweat glands of members of the family Bovidae and that this is not due to the release of transmitter substance nor to stimulation of adrenergic receptors, but is due to direct stimulation of the sweat glands themselves.

Formaldehyde-treated casein-safflower oil supplement for dairy cows. II. Effect on the fatty-acid composition of plasma and milk lipids

This study reports the effect of feeding formaldehyde-treated or untreated spray-dried casein–safflower oil (1:1, w/w) particles on the fatty-acid composition of milk and plasma lipids of cows.

When the formaldehyde-treated particles were given to Jersey, Sahiwal and Jersey × Sahiwal crossbred cows (1 kg per cow per day) the linoleic acid (18:2) present in the safflower oil was not hydrogenated by the rumen micro-organisms and was incorporated into milk fat.

When the untreated supplement was fed, however, the 18:2 fatty acid was hydrogenated in the rumen and there was an increased proportion of octadecenoic acid (18:1) in the milk fat.

The increased proportions of 18:2 (treated supplement) and 18:1 (untreated supplement) were associated with decreased proportions of palmitic (16:0) and myristic (14:0) acids in the milk fat. All 3 breeds showed similar responses.

The fatty-acid composition of plasma triglycerides, which are an important source of long-chain fatty acids for mammary-gland lipogenesis, was similarly affected. Furthermore, there were significant changes in the fatty-acid composition of other plasma lipids (e.g. phospholipids and cholesteryl esters). The interrelationships between dietary, plasma and milk fatty-acid compositions are discussed.

Formaldehyde-treated casein-safflower oil supplement for dairy cows. I. Effect on milk composition

The effects of feeding lactating cows a daily supplement of 1 kg formaldehyde-treated casein–safflower oil (1:1, w/w) on the milk composition are reported. Three breeds, Jersey, Sahiwal and Sahiwal × Jersey crossbred were used.

The formaldehyde treatment not only eliminated the suppressing effect on the milk, fat and protein yields and on the fat and protein contents usually encountered when such a level of unsaturated oil is fed to lactating cows, but also resulted, on the average, in 15 and 6% increases in the fat and protein contents respectively.

The formaldehyde-treated dietary supplement also caused a decline of 5% in the solids-not-fat content, presumably due to a decrease in the lactose content.

It is suggested that the formaldehyde treatment protects the casein from the ruminal proteolysis and this in turn prevents the encapsulated unsaturated oil from biohydrogenation and eliminates the diverse effects on rumen microflora and environment.

Sweating rate at different body regions in cattle and its correlation with some quantitative components of sweat gland volume for a given area of skin

Sweating rates at five body regions on four Jersey and four Sahiwal x Jersey crossbred heifers were measured in a hot room under three treatments differing in temperature and duration. The correlations between sweating rate and some quantitative components of sweat gland volume for a given area of skin were examined. Differences in sweating rate between body regions, interactions between breed and body region in sweating rate, and differences in sweating rate for the various treatments were all shown to be statistically significant. There was no significant interaction between body regions and treatment in sweating rate.Between body regions within an animal, there was a positive correlation between sweat gland population density and sweating rate and a negative correlation between mean sweat gland volume and sweating rate. This negative correlation was associated with the fact that regions with high sweat gland population density also tended to have smaller sweat glands and vice versa. Indications of a positive correlation between the total sweat gland volume per unit area and sweating rate were also found, though none of these approached statistical significance.

Variation in hair characters over the body in Sahiwal Zebu and Jersey cattle

In both Sahiwals and Jerseys, mean hair length and diameter increased posteriorly. The length/diameter ratio, and diameters of non-medullated hairs, of medullated hairs, and of the medulla itself also varied between positions, as did the percentage of medullated hairs. Jerseys had greater hair length than Sahiwals at all positions (average + 80%) though in the majority of positions Sahiwals had a greater hair diameter than Jerseys (average + 12%). Coefficients of variation in hair length were similar for the two breeds. In general, variation of hair diameter within positions was slightly greater in Sahiwals, but differences between positions in the variability of hair diameter were small. In all positions, Jerseys had greater hair length/diameter ratios than Sahiwals (average + 90%). In the majority of positions, Jerseys had a greater percentage of medullated hairs than Sahiwals. The mean percentage of medullated hairs for Jerseys was 88% and for Sahiwals 85%, whilst the mean diameters of both medulla and medullated hairs were greater in Sahiwals (39.4 and 62 1 µ) than in Jerseys (26.7 and 54.2 µ). Diameters of non-medullated hairs differed little between the two breeds, being 44.40 µ for Sahiwals and 40.82 µ for Jerseys. Only differences between the two breeds in hair length, hair length/diameter ratio, and medulla diameter were statistically significant. The percentage of medullated fibres was the only character for which the commonly used midside sample provided estimates which were within 10% of the mean over all positions for each breed. Estimates of means and coefficients of variation for other characters are likely to be misleading if based on a single sample from this region. Positions providing better estimates for other traits are: mean hair length in Sahiwals, position 2; C.V. of mean hair length in Jerseys, position 12; mean hair diameter in Sahiwals, position 4; C.V. of mean hair diameter in Jerseys, position 4; mean hair length/diameter ratio in Sahiwals, position 8.

Quantitative and morphological variation of sweat glands, skin thickness, and skin shrinkage over various body regions of Sahiwal Zebu and Jersey cattle

By comparison with Jerseys the sweat glands of Sahiwals were 70% longer, 55% wider, and 315% greater in mean volume. Total sweat gland volume per unit area of skin was 340%, greater and skin thickness was 60% greater, but skin shrinkage was 30%, less. The density of sweat glands was 1130/cm2 for Jerseys and 1200/cm2 for Sahiwals. In almost all animals the characters varied significantly between the various body positions, and in most cases showed trends. Values for the generally adopted midside sampling position were usually within 10% of the mean value for all positions. Sweat gland shape varied over the body. Most of the shapes observed in the two species were present in one position or another within each animal.

The effect of feeding on evaporative heat loss and body temperature in Zebu and Jersey heifers

Some physiological responses to moderate (70–80°F dry bulb and 60–70° wet bulb) ante-room and high (103° dry bulb and 83° wet bulb) hot room temperatures by two Jersey and two Zebu heifers under alternate conditions of normal feed intake and fasting are reported. At moderate temperatures both breeds exhibited a diurnal rhythm in feed and water consumption and in skin temperature, sweating rate, rectal temperature, and respiration rate. In the case of skin temperature, sweating rate, and respiration rate this diurnal rhythm disappeared in the hot room. In the hot room, water consumption increased for all animals. Feed intake was depressed in Jerseys but not in Zebus. In the ante-room, animals tended to have higher sweating rates and rectal temperatures when fed than when not fed. Fed animals did not have uniformly greater skin temperatures in the hot room, but sweating rates, rectal temperatures, and respiration rates were greater. Jerseys had greater sweating rates and lower rectal temperatures than Zebus at ante-room temperatures, but Zebus had greater sweating rates and lower rectal temperatures in the hot room. When fed, Jerseys failed to control their temperatures in the hot room, despite large increases in sweating and respiration rates and a reduction in appetite; whereas Zebus maintained their appetites, and slightly reduced rectal temperatures, by means of their greatly increased sweating rate and a slight increase in respiration rate. Differences between Jerseys and Zebus in sweat gland volume were of the order previously reported for these breeds, and differences in population density were in accordance with differences in body size. The Jersey having the smallest sweat glands also had the lowest number per unit area, and sweated less than its Jersey mate.