Experimental Limits on Solar Reflected Dark Matter with a New Approach on Accelerated-Dark-Matter-Electron Analysis in Semiconductors

Recently a dark matter-electron (DM-electron) paradigm has drawn much attention. Models beyond the standard halo model describing DM accelerated by high energy celestial bodies are under intense examination as well. In this Letter, a velocity components analysis (VCA) method dedicated to swift analysis of accelerated DM-electron interactions via semiconductor detectors is proposed and the first HPGe detector-based accelerated DM-electron analysis is realized. Utilizing the method, the first germanium based constraint on sub-GeV solar reflected DM-electron interaction is presented with the 205.4  kg·day dataset from the CDEX-10 experiment. In the heavy mediator scenario, our result excels in the mass range of 5-15  keV/c^{2}, achieving a 3 orders of magnitude improvement comparing with previous semiconductor experiments. In the light mediator scenario, the strongest laboratory constraint for DM lighter than 0.1  MeV/c^{2} is presented. The result proves the feasibility and demonstrates the vast potential of the VCA technique in future accelerated DM-electron analyses with semiconductor detectors.

Ulinastatin inhibits the metastasis of nasopharyngeal carcinoma by involving uPA/uPAR signaling

Distant metastasis is the primary reason for treatment failure in patients with nasopharyngeal carcinoma (NPC). In this study, we investigated the effect of ulinastatin (UTI) on NPC metastasis and its underlying mechanism. Highly-metastatic NPC cell lines S18 and 58F were treated with UTI and the effect on cell proliferation, migration, and invasion were determined by MTS and Transwell assays. S18 cells with luciferase-expressing (S18-1C3) were injected into the left hind footpad of nude mice to establish a model of spontaneous metastasis from the footpad to popliteal lymph node (LN). The luciferase messenger RNA (mRNA) was measured by quantitative polymerase chain reaction (qPCR), and the metastasis inhibition rate was calculated. Key molecular members of the UTI-related uPA, uPAR, and JAT/STAT3 signaling pathways were detected by qPCR and immunoblotting. UTI suppressed the migration and infiltration of S18 and 5-8F cells and suppressed the metastasis of S18 cells in vivo without affecting cell proliferation. uPAR expression decreased from 24 to 48 h after UTI treatment. The antimetastatic effect of UTI is partly due to the suppression of uPA and uPAR. UTI partially suppresses NPC metastasis by downregulating the expression of uPA and uPAR.

SPI1-Mediated Upregulation of the CST1 Gene as an Independent Poor Prognostic Factor Accelerates Metastasis in Esophageal Squamous Cell Carcinoma (ESCC) by Interacting with MMP2

BACKGROUND

Esophageal squamous cell carcinoma (ESCC) is a highly lethal tumor type, but studies on the ESCC tumor microenvironment are limited. We found that cystatin SN (CST1) plays an important role in the ESCC tumor microenvironment. CST1 has been reported to act as an oncogene in multiple human cancers, but its clinical significance and underlying mechanism in ESCC remain elusive.

METHODS

We performed ESCC gene expression profiling with data from RNA-sequencing and public databases and found CST1 upregulation in ESCC. Then, we assessed CST1 expression in ESCC by RT‒qPCR and Western blot analysis. In addition, immunohistochemistry (IHC) and enzyme-linked immunosorbent assay (ELISA) were used to estimate the expression of CST1 in ESCC tissue and serum. Moreover, further functional experiments were conducted to verify that the gain and loss of CST1 in ESCC cell lines significantly influenced the proliferation and metastasis of ESCC. Mass spectrometry, coimmunoprecipitation, and gelatin zymography experiments were used to validate the interaction between CST1 and matrix metalloproteinase 2 (MMP2) and the mechanism of CST1 influence on metastasis in ESCC.

RESULTS

Here, we found that CST1 expression was significantly elevated in ESCC tissues and serum. Moreover, compared with patients with low CST1 expression, patients with high CST1 expression had a worse prognosis. Overall survival (OS) and disease-free survival (DFS) were significantly unfavorable in the high CST1 expression subgroup. Likewise, the CST1 level was significantly increased in ESCC serum compared with healthy control serum, indicating that CST1 may be a potential serum biomarker for diagnosis, with an area under the curve (AUC) = 0.9702 and p < 0.0001 by receiver operating curve (ROC) analysis. Furthermore, upregulated CST1 can promote the motility and metastatic capacity of ESCC in vitro and in vivo by influencing epithelial mesenchymal transition (EMT) and interacting with MMP2 in the tumor microenvironment (TME).

CONCLUSIONS

Collectively, the results of this study indicated that high CST1 expression mediated by SPI1 in ESCC may serve as a potentially prognostic and diagnostic predictor and as an oncogene to promote motility and metastatic capacity of ESCC by influencing EMT and interacting with MMP2 in the TME.

Bacillus amyloliquefaciens PMB05 Increases Resistance to Bacterial Wilt by Activating Mitogen-Activated Protein Kinase and Reactive Oxygen Species Pathway Crosstalk in Arabidopsis thaliana

Bacterial wilt caused by Ralstonia solanacearum can infect many crops, causing significant losses worldwide. The use of beneficial microorganisms is considered a feasible method for controlling this disease. Our previous study showed that Bacillus amyloliquefaciens PMB05 can control bacterial wilt through intensifying immune signals triggered by a pathogen-associated molecular pattern (PAMP) from R. solanacearum. It is still uncertain whether induction of the mitogen-activated protein kinase (MAPK) pathway during PAMP-triggered immunity (PTI) is responsible for enhancing disease resistance. To gain more insights on how the presence of PMB05 regulates PTI signaling, its association with the MAPK pathway was assayed. Our results showed that the activation of MPK3/6 and expression of wrky22 upon treatment with the PAMP, PopW, was increased during co-treatment with PMB05. Moreover, the disease resistance conferred by PMB05 to bacterial wilt was abolished in mekk1, mkk5, and mpk6 mutants. To determine the relationship between the MAPK pathway and plant immune signals, the assay on reactive oxygen species (ROS) generation and callose deposition showed that only the ROS generation was strongly reduced in these mutants. Because ROS generation is highly correlated with RbohD, the results revealed that the effects of PMB05 on both PopW-induced ROS generation and disease resistance to bacterial wilt were eliminated in the rbohD mutant, suggesting that the generation of ROS is also required for PMB05-enhanced disease resistance. Taken together, we concluded that the crosstalk between the initiation of ROS generation and further activation of the MAPK pathway is necessary when PMB05 is used to improve disease resistance to bacterial wilt. [Formula: see text] Copyright © 2022 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license.

Constraints on Sub-GeV Dark Matter-Electron Scattering from the CDEX-10 Experiment

We present improved germanium-based constraints on sub-GeV dark matter via dark matter-electron (χ-e) scattering using the 205.4  kg·day dataset from the CDEX-10 experiment. Using a novel calculation technique, we attain predicted χ-e scattering spectra observable in high-purity germanium detectors. In the heavy mediator scenario, our results achieve 3 orders of magnitude of improvement for m_{χ} larger than 80  MeV/c^{2} compared to previous germanium-based χ-e results. We also present the most stringent χ-e cross-section limit to date among experiments using solid-state detectors for m_{χ} larger than 90  MeV/c^{2} with heavy mediators and m_{χ} larger than 100  MeV/c^{2} with electric dipole coupling. The result proves the feasibility and demonstrates the vast potential of a new χ-e detection method with high-purity germanium detectors in ultralow radioactive background.

Exotic Dark Matter Search with the CDEX-10 Experiment at China's Jinping Underground Laboratory

A search for exotic dark matter (DM) in the sub-GeV mass range has been conducted using 205 kg day data taken from a p-type point contact germanium detector of the CDEX-10 experiment at China's Jinping underground laboratory. New low-mass dark matter searching channels, neutral current fermionic DM absorption (χ+A→ν+A) and DM-nucleus 3→2 scattering (χ+χ+A→ϕ+A), have been analyzed with an energy threshold of 160 eVee. No significant signal was found; thus new limits on the DM-nucleon interaction cross section are set for both models at the sub-GeV DM mass region. A cross section limit for the fermionic DM absorption is set to be 2.5×10^{-46}  cm^{2} (90% C.L.) at DM mass of 10  MeV/c^{2}. For the DM-nucleus 3→2 scattering scenario, limits are extended to DM mass of 5 and 14  MeV/c^{2} for the massless dark photon and bound DM final state, respectively.

Progress in the Preparation of Functional and (Bio)Degradable Polymers via Living Polymerizations

This review presents the latest developments in (bio)degradable approaches and functional aliphatic polyesters and polycarbonates prepared by typical ring-opening polymerization (ROP) of lactones and trimethylene carbonates. It also considers several recent innovative synthetic methods including radical ring-opening polymerization (RROP), atom transfer radical polyaddition (ATRPA), and simultaneous chain- and step-growth radical polymerization (SCSRP) that produce aliphatic polyesters. With regard to (bio)degradable approaches, we have summarized several representative cleavable linkages that make it possible to obtain cleavable polymers. In the section on functional aliphatic polyesters, we explore the syntheses of specific functional lactones, which can be performed by ring-opening copolymerization of typical lactone/lactide monomers. Last but not the least, in the recent innovative methods section, three interesting synthetic methodologies, RROP, ATRPA, and SCSRP are discussed in detail with regard to their reaction mechanisms and polymer functionalities.

Geographical disparities in the prognosis of patients with nasopharyngeal carcinoma treated with intensity-modulated radiation therapy: a large institution-based cohort study from an endemic area

OBJECTIVES

Geographical disparities have been identified as a specific barrier to cancer screening and a cause of worse outcomes for patients with cancer. In the present study, our aim was to assess the influence of geographical disparities on the survival outcomes of patients with nasopharyngeal carcinoma (NPC) treated with intensity-modulated radiation therapy (IMRT).

DESIGN

Cohort study.

SETTING

Guangzhou, China.

PARTICIPANTS

A total of 1002 adult patients with NPC (724 males and 278 females) who were classified by area of residence (rural or urban) received IMRT from 1 January 2010 to 31 December 2014, at Sun Yat-sen University Cancer Center. Following propensity score matching (PSM), 812 patients remained in the analysis.

MAIN OUTCOME MEASURES

We used PSM to reduce the bias of variables associated with treatment effects and outcome prediction. Survival outcomes were estimated using the Kaplan-Meier method and compared by the log-rank test. Multivariate Cox regression was used to identify independent prognostic factors.

RESULTS

In the matched cohort, 812 patients remained in the analysis. Kaplan-Meier survival analysis revealed that the rural group was significantly associated with worse overall survival (OS, p<0.001), disease-free survival (DFS, p<0.001), locoregional relapse-free survival (LRRFS, p=0.003) and distant metastasis-free survival (DMFS, p<0.001). Multivariate Cox regression showed worse OS (HR=3.126; 95% CI 1.902 to 5.138; p<0.001), DFS (HR=2.579; 95% CI 1.815 to 3.665; p<0.001), LRRFS (HR=2.742; 95% CI 1.359 to 5.533; p=0.005) and DMFS (HR=2.461; 95% CI 1.574 to 3.850; p<0.001) for patients residing in rural areas.

CONCLUSIONS

The survival outcomes of patients with NPC who received the same standardised treatment were significantly better in urban regions than in rural regions. By analysing the geographic disparities in outcomes for NPC, we can guide the formulation of healthcare policies.

LACTB promotes metastasis of nasopharyngeal carcinoma via activation of ERBB3/EGFR-ERK signaling resulting in unfavorable patient survival

Nasopharyngeal carcinoma (NPC) originates in the nasopharyngeal epithelium and has the highest metastatic rate among head and neck cancers. Distant metastasis is the main reason for treatment failure with the underlying mechanisms remaining unclear. By comparing the expression profiling of NPCs versus non-cancerous nasopharyngeal tissues, we found LACTB was highly expressed in the tumor tissues. We found that elevated expression of the LACTB protein in primary NPCs correlated with poorer patient survival. LACTB is known to be a serine protease and a ubiquitous mitochondrial protein localized in the intermembrane space. Its role in tumor biology remains controversial. We found that the different methylation pattern of LACTB promoter led to its differential expression in NPC cells. Overexpressing LACTB in NPC cells promoted their motility in vitro and metastasis in vivo. While knocking down LACTB reduced the metastasis capability of NPC cells. However, LACTB did not influence cellular proliferation. We further found the role of LACTB in promoting NPC metastasis depended on the activation of ERBB3/EGFR-ERK signaling, which in turn, affected the stability and the following acetylation of histone H3. These findings may shed light on unveiling the mechanisms of NPC metastasis.

AKR1C2 acts as a targetable oncogene in esophageal squamous cell carcinoma via activating PI3K/AKT signaling pathway

The aldo-keto reductases family 1 member C2 (AKR1C2) has critical roles in the tumorigenesis and progression of malignant tumours. However, it was also discovered to have ambiguous functions in multiple cancers and till present, its clinical significance and molecular mechanism in oesophageal squamous cell carcinoma (ESCC) has been unclear. The aim of this study was to explore the role of AKR1C2 in the tumorigenesis of ESCC. Here, we showed that AKR1C2 expression was found to be up-regulated in ESCC tissues and was significantly associated with pathological stage, lymph node metastasis and worse outcomes. Functional assays demonstrated that an ectopic expression of AKR1C2 in ESCC cells resulted in increased proliferation, migration and cisplatin resistance, while knockdown led to inversing effects. Bioinformation analyses and mechanistic studies demonstrated that AKR1C2 activated the PI3K/AKT signalling pathway, furthermore, the inhibitor of PI3K or the selective inhibitor of AKR1C2 enzyme activity could reverse the aggressiveness and showed synergistic antitumour effect when combined with cisplatin, both in vitro and in vivo. In conclusion, Our findings revealed that AKR1C2 could function as an oncogene by activating the PI3K/AKT pathway, as a novel prognostic biomarker and/or as a potential therapeutic target to ESCC.

Direct Detection Constraints on Dark Photons with the CDEX-10 Experiment at the China Jinping Underground Laboratory

We report constraints on the dark photon effective kinetic mixing parameter (κ) with data taken from two p-type point-contact germanium detectors of the CDEX-10 experiment at the China Jinping Underground Laboratory. The 90% confidence level upper limits on κ of solar dark photon from 205.4 kg-day exposure are derived, probing new parameter space with masses (m_{V}) from 10 to 300  eV/c^{2} in direct detection experiments. Considering dark photon as the cosmological dark matter, limits at 90% confidence level with m_{V} from 0.1 to 4.0  keV/c^{2} are set from 449.6 kg-day data, with a minimum of κ=1.3×10^{-15} at m_{V}=200  eV/c^{2}.

Search for Light Weakly-Interacting-Massive-Particle Dark Matter by Annual Modulation Analysis with a Point-Contact Germanium Detector at the China Jinping Underground Laboratory

We present results on light weakly interacting massive particle (WIMP) searches with annual modulation (AM) analysis on data from a 1-kg mass p-type point-contact germanium detector of the CDEX-1B experiment at the China Jinping Underground Laboratory. Datasets with a total live time of 3.2 yr within a 4.2-yr span are analyzed with analysis threshold of 250 eVee. Limits on WIMP-nucleus (χ-N) spin-independent cross sections as function of WIMP mass (m_{χ}) at 90% confidence level (C.L.) are derived using the dark matter halo model. Within the context of the standard halo model, the 90% C.L. allowed regions implied by the DAMA/LIBRA and CoGeNT AM-based analysis are excluded at >99.99% and 98% C.L., respectively. These results correspond to the best sensitivity at m_{χ}<6  GeV/c^{2} among WIMP AM measurements to date.

Constraints on Spin-Independent Nucleus Scattering with sub-GeV Weakly Interacting Massive Particle Dark Matter from the CDEX-1B Experiment at the China Jinping Underground Laboratory

We report results on the searches of weakly interacting massive particles (WIMPs) with sub-GeV masses (m_{χ}) via WIMP-nucleus spin-independent scattering with Migdal effect incorporated. Analysis on time-integrated (TI) and annual modulation (AM) effects on CDEX-1B data are performed, with 737.1 kg day exposure and 160 eVee threshold for TI analysis, and 1107.5 kg day exposure and 250 eVee threshold for AM analysis. The sensitive windows in m_{χ} are expanded by an order of magnitude to lower DM masses with Migdal effect incorporated. New limits on σ_{χN}^{SI} at 90% confidence level are derived as 2×10^{-32}∼7×10^{-35}  cm^{2} for TI analysis at m_{χ}∼50-180  MeV/c^{2}, and 3×10^{-32}∼9×10^{-38}  cm^{2} for AM analysis at m_{χ}∼75  MeV/c^{2}-3.0  GeV/c^{2}.

GTSE1 is involved in breast cancer progression in p53 mutation-dependent manner

Background

With the rapid development of the high throughput detection techniques, tumor-related Omics data has become an important source for studying the mechanism of tumor progression including breast cancer, one of the major malignancies worldwide. A previous study has shown that the G2 and S phase-expressed-1 (GTSE1) can act as an oncogene in several human cancers. However, its functional roles in breast cancer remain elusive.

Method

In this study, we analyzed breast cancer data downloaded from The Cancer Genome Atlas (TCGA) databases and other online database including the Oncomine, bc-GenExMiner and PROGgeneV2 database to identify the molecules contributing to the progression of breast cancer. The GTSE1 expression levels were investigated using qRT-PCR, immunoblotting and IHC. The biological function of GTSE1 in the growth, migration and invasion of breast cancer was examined in MDA-MB-231, MDA-MB-468 and MCF7 cell lines. The in vitro cell proliferative, migratory and invasive abilities were evaluated by MTS, colony formation and transwell assay, respectively. The role of GTSE1 in the growth and metastasis of breast cancer were revealed by in vivo investigation using BALB/c nude mice.

Results

We showed that the expression level of GTSE1 was upregulated in breast cancer specimens and cell lines, especially in triple negative breast cancer (TNBC) and p53 mutated breast cancer cell lines. Importantly, high GTSE1 expression was positively correlated with histological grade and poor survival. We demonstrated that GTSE1 could promote breast cancer cell growth by activating the AKT pathway and enhance metastasis by regulating the Epithelial-Mesenchymal transition (EMT) pathway. Furthermore, it could cause multidrug resistance in breast cancer cells. Interestingly, we found that GTSE1 could regulate the p53 function to alter the cell cycle distribution dependent on the mutation state of p53.

Conclusion

Our results reveal that GTSE1 played a key role in the progression of breast cancer, indicating that GTSE1 could serve as a novel biomarker to aid in the assessment of the prognosis of breast cancer.

Electronic supplementary material

The online version of this article (10.1186/s13046-019-1157-4) contains supplementary material, which is available to authorized users.

Limits on Light Weakly Interacting Massive Particles from the First 102.8 kg×day Data of the CDEX-10 Experiment

We report the first results of a light weakly interacting massive particles (WIMPs) search from the CDEX-10 experiment with a 10 kg germanium detector array immersed in liquid nitrogen at the China Jinping Underground Laboratory with a physics data size of 102.8 kg day. At an analysis threshold of 160 eVee, improved limits of 8×10^{-42} and 3×10^{-36}  cm^{2} at a 90% confidence level on spin-independent and spin-dependent WIMP-nucleon cross sections, respectively, at a WIMP mass (m_{χ}) of 5  GeV/c^{2} are achieved. The lower reach of m_{χ} is extended to 2  GeV/c^{2}.

[A prospective pilot study of combined intra-operative radiotherapy for centrally located hepatocellular carcinomas]

Objective: To carry out a prospective cohort study of combined intra-operative radiotherapy for centrally located hepatocellular carcinomas (HCC) and to observe the safety and postoperative complications. Methods: A total of 79 patients with centrally located HCC who underwent hepatectomy were divided into two groups: experimental group (combined with targeted intra-operative radiotherapy, 32 cases) and control group (single surgical operation, 47 cases). Patients in the experimental group received intra-operative electron radiotherapy after tumor resection, while patients in the control group received to intra-operative electron radiotherapy.The haemorrhagia amount and operation time during the operation, intra-operative liver function and the recovery of liver and gastrointestinal tract of patients in these two groups were compared. Results: No postoperative 30-day mortality was observed in all of the patients. The average total operation time of patients in the experimental group was (319±76) min, significantly longer than (233±76) min of the control group (P<0.001). The average aspartate transaminase (AST) level of patients in the experimental group at postoperative day 1 was 562.5 U/L, significantly higher than 347.0 U/L of control group (P=0.031). However, the average prothrombin activity levels of patients in the experimental group at postoperative day 3 and day 7 were (68.3±17.9)% and (73.4±10.2)%, respectively, significantly lower than (78.9±15.9)% and (80.0±10.6)% of control group (both P<0.05). There were no significant differences of tumor volume, differentiation degree, satellite lesion, dorsal membrane invasion, microvascular invasion between these two groups (all P>0.05). There were no significant differences of hospital stay, ventilation time, the incidence of hepatic insufficiency, ascites, pleural effusion, infection, biliary fistula between these two groups (all P>0.05). There were no significant differences of alanine aminotransferase (ALT), albumin, total bilirubin between these two groups at postoperative day 1, 3, 5 and 7 (all of P>0.05). Conclusion: The resection of centrally located HCC combined with intra-operative radiotherapy may increase the total operation time, delay the early postoperative recovery of liver function, but it is still safe and feasible. Trial registration: National Cancer Centre /Cancer Hospital, Chinese Academy of Medical Sciences, ChiCTR-TRC-12002802.

Study of inactive layer uniformity and charge collection efficiency of a p-type point-contact germanium detector

The characteristics of the surface inactive layer of a 1-kg-mass p-type point-contact germanium detector were studied. The thickness of the inactive layer and its uniformity on the top and lateral surfaces were measured. A charge collection efficiency function was developed according to the Monte Carlo simulation to describe the charge collection capacity along the depth within this inactive layer. In the energy range below 18keV, the surface, bulk, and total spectra of ⁵⁷Co, ¹³³Ba, ¹³⁷Cs, and ⁶⁰Co from simulations based on the charge collection efficiency function were well consistent with those from experiments.

[Analysis of clinicopathological features and prognosis of 98 cases of small hepatocellular carcinoma]

Objective: To analyze the clinicopathological features and prognosis of patients with small hepatocellular carcinoma. Methods: The clinicopathological and follow-up data of 98 patients with small hepatocellular carcinoma who underwent R0 resection from January 2009 to December 2013 were analyzed retrospectively. Results: All of the patients were followed up. Their postoperative 1-year, 3-year and 5-year overall survival rates were 99.0%, 91.7%, and 76.3%, respectively. Their postoperative median overall survival (OS) period was 52 months. The postoperative progression-free survival rates were 86.7%, 66.2% and 55.0%, respectively, and the median progression-free survival (PFS) period was 43.5 months. The univariate analysis showed that satellite nodules, liver capsule invasion and postoperative recurrence time were associated with OS (P<0.05), and long-term heavy drinking, satellite nodules and liver capsule invasion with PFS (P<0.05). The multivariate analysis indicated that long-term heavy drinking was an independent factor influencing the progression-free survival period of patients with small hepatocellular carcinoma (P=0.003) and postoperative recurrence time and liver capsule invasion were independent factors affecting their overall survival period (P<0.05). Conclusions: The treatment of small hepatocellular carcinoma still concentrates on the active treatment of surgery. It is beneficial to patients to minimize the resection scope of normal liver under the premise of R0 removal of tumor. Postoperative recurrence time of ≤2 years suggests poor prognosis of small hepatocellular carcinoma. Long-term heavy drinking can accelerate the recurrence of small hepatocellular carcinoma.

Limits on spin-independent couplings of WIMP dark matter with a p-type point-contact germanium detector

We report new limits on a spin-independent weakly interacting massive particle (WIMP)-nucleon interaction cross section using 39.5 kg days of data taken with a p-type point-contact germanium detector of 840 g fiducial mass at the Kuo-Sheng Reactor Neutrino Laboratory. Crucial to this study is the understanding of the selection procedures and, in particular, the bulk-surface events differentiation at the sub-keV range. The signal-retaining and background-rejecting efficiencies were measured with calibration gamma sources and a novel n-type point-contact germanium detector. Part of the parameter space in the cross section versus WIMP-mass implied by various experiments is probed and excluded.

Two-dimensional PPLN for simultaneous laser Q-switching and optical parametric oscillation in a Nd:YVO4 laser

We report on a tunable intracavity optical parametric oscillator (IOPO) achieved using a two-dimensional (2D) periodically poled lithium niobate (PPLN) as simultaneously an electro-optic (EO) Bragg Q-switch and an optical frequency mixer (OFM) in a diode-pumped Nd:YVO(4) laser. The 2D periodic domain inversion structure is designed to provide two orthogonal reciprocal vectors to respectively satisfy the phase-matching conditions required by the two quasi-phase-matching devices (i.e., the PPLN EO Bragg deflector and the PPLN OFM). At a ~140-V Q-switching voltage and a 1-kHz switching rate, we obtained a signal wave at 1550 nm with a pulse energy of 9.7 μJ (corresponding to a peak power of ~2.4 kW) from the IOPO at 9.1-W diode pump power. Simultaneously we also observed multi-wavelength generation from the system originating in the single-pass parametric conversions in the 2D nonlinear photonic crystal structure. Temperature tuning of the IOPO signal wavelength in the eye-safe region was also demonstrated.

Fiber-laser-pumped CW OPO for red, green, blue laser generation

We report a CW, watt-level, red, green, and blue (RGB) laser pumped by an economical multimode (1-nm linewidth) Yb-fiber laser at 1.064 mum. A singly resonant optical parametric oscillator at 1.56 mum has two intracavity sum-frequency generators for red and blue laser generation. An extracavity second harmonic generator converts the residual pump power into green laser radiation. At 25-W pump power, the laser generated 3.9, 0.456, and 0.49 W at 633, 532, and 450 nm, respectively. The multimode pump laser offers a large temperature bandwidth for operating the RGB OPO without the need of a precision crystal temperature stabilizer.

Thermal waveguide OPO

We report a mid-infrared, CW singly resonant optical parametric oscillator (OPO) with a thermally induced waveguide in its gain crystal. We measured a numerical aperture of 0.0062 for the waveguide at 80-W intracavity power at 3.2 microm. This thermal-guiding effect benefits to the stable operation of an OPO and improves the parametric conversion efficiency by more than a factor of two when compared with that without thermal guiding.

Observation of thermal-induced optical guiding and bistability in a mid-IR continuous-wave, singly resonant optical parametric oscillator

We report the observation of thermal-induced optical guiding and bistability in a mid-IR cw, singly resonant optical parametric oscillator (SRO) at approximately 3.2 microm. The SRO employs a MgO:PPLN crystal as the gain medium and a 1-nm-linewidth Yb-fiber laser at 1.064 microm as the pump source. As soon as the pump power reaches the thermal guiding threshold at 16.5 W, the SRO shows a step increase in the parametric efficiency by a factor of 2.5. At 25 W pump power, the SRO generated 5.3 and 1.2 W at 1.58 and 3.23 microm, respectively, with single-longitudinal-mode performance for the 3.23 microm radiation.

Low-threshold, narrow-line THz-wave parametric oscillator with an intra-cavity grazing-incidence grating

We report a low-threshold, narrow-line THz-wave parametric oscillator with an intra-cavity grazing-incidence grating and a 1-mm thick, 45-mm long lithium-niobate planar waveguide. When pumped by an actively Q-switched Nd:YAG laser, the threshold energy and intensity of the parametric oscillator were about 2.2 mJ and 70 MW/cm(2), respectively. The linewidths of the output THz wave were 12 and 134 GHz with and without the intra-cavity grating, respectively.

Forward and backward terahertz-wave difference-frequency generations from periodically poled lithium niobate

We report terahertz-wave generation in the wavelength range of 190 - 210 and 457 - 507 microm from forward and backward difference frequency generations, respectively, in a 3.2-cm long multi-grating periodically poled lithium niobate (PPLN) crystal. The grating period of the PPLN crystal varies form 63 to 70 microm in 1-microm increments. The extraordinary refractive index of lithium niobate in the THz-wave range was precisely deduced from the quasi-phase-matching condition of the difference frequency generations.

Monolithically integrated laser Bragg Q-switch and wavelength converter in a PPLN crystal

We report a periodically poled lithium niobate (PPLN) crystal for both temperature-insensitive laser Q-switching and temperature-tuned wavelength conversion. The PPLN crystal consists of two sections, a 20.3-mum period section functioning as an electro-optic Bragg grating for Qswitching a diode-pumped Nd:YVO4 laser at 1064 nm and a 31-mum-period section functioning as an optical parametric generator for down converting the generated 1064-nm laser. When driving the PPLN Bragg grating with 170-V voltage pulses, we measured 181 muJ pulse energy at 1064 nm from the Nd:YVO4 laser pumped by 20.4 W diode power. The 181-muJ pulsed laser was further converted into mid-infrared radiation in the monolithic PPLN crystal with 35% parametric efficiency. The wavelengths were broadly tunable in the range of 1.75-1.88 mum (signal) and 2.7-2.44 mum (idler) via temperature without affecting the performance of the PPLN Bragg Qswitch.

Electro-optic periodically poled lithium niobate Bragg modulator as a laser Q-switch

We report an electro-optic Bragg modulator using a periodically poled lithium niobate (PPLN) crystal. We measured a half-wave voltage of 160 V when transmitting a 1064 nm laser through a 14.2 mm long, 780 microm thick, 20.13 microm period PPLN crystal at the Bragg angle. We also demonstrated a Q-switched Nd:YVO(4) laser using such a PPLN Bragg modulator as its Q-switch, producing 7.8 ns, 201 microJ pulses at a 10 kHz repetition rate when pumped by a 19.35 W diode laser at 808 nm.

Light-enhanced electro-optic spectral tuning in annealed proton-exchanged periodically poled lithium niobate channel waveguides

We report the observation of light-enhanced electro-optic spectral tuning in annealed proton-exchanged, asymmetric domain-duty-cycle periodically poled lithium niobate (PPLN) channel waveguides for second-harmonic generation. The spectral tuning rate was increased rapidly from 0.07 nm/(kV/mm) to a saturated value of 0.32 nm/(kV/mm) in a 30%/70% domain-duty-cycle PPLN waveguide when the fundamental pump power near 1534 nm was increased from 0.6 to 46 mW. The second-harmonic laser power at 767 nm was identified to be the source enhancing the spectral tuning.

Enhanced terahertz-wave parametric generation and oscillation in lithium niobate waveguides at terahertz frequencies

We observed parametric-generation efficiency of 1.61% from 1064 to 1071 nm and at 162 microm in a 0.5 mm thick, 45 mm long z-cut congruent lithium niobate waveguide with a pump energy of 2.2 mJ and a pump pulse width of 5.8 ns. We also measured an ultralow-threshold intensity of 70 MW/cm2 for a 1064 nm pumped parametric oscillator resonating at 1071 nm and emitting at 162 microm with a 1 mm thick, 45 mm long lithium niobate waveguide.

Limit on the electron neutrino magnetic moment from the kuo-sheng reactor neutrino experiment

A search of neutrino magnetic moment was carried out at the Kuo-Sheng Nuclear Power Station at a distance of 28 m from the 2.9 GW reactor core. With a high purity germanium detector of mass 1.06 kg surrounded by scintillating NaI(Tl) and CsI(Tl) crystals as anti-Compton detectors, a detection threshold of 5 keV and a background level of 1 kg(-1) keV(-1) day(-1) at 12-60 keV were achieved. Based on 4712 and 1250 h of reactor ON and OFF data, respectively, the limit on the neutrino magnetic moment of mu(nu;(e))<1.3x10(-10)mu(B) at 90% confidence level was derived. An indirect bound of the nu;(e) radiative lifetime of m(3)(nu)tau(nu)>2.8x10(18) eV(3) s can be inferred.

Molecular cloning and sequence analysis of full-length cDNAs encoding new group of Cyn d 1 isoallergens

BACKGROUND

Cyn d 1, the major allergen of Bermuda grass pollen, contains some acidic/basic isoforms. The N-terminal amino acid sequences of some acidic Cyn d 1 isoforms were found to be different from those of Cyn d 1 cDNA clones identified previously.

METHODS

A predicted 17-meric oligonucleotide probe was designed to fish the unidentified isoallergen cDNAs out of BGP cDNA library. The reactive clones were isolated and verified by sequencing. Two of them were expressed in the yeast Pichia pastoris to obtain recombinant Cyn d 1 proteins.

RESULTS

All four cDNA clones encode the full-length Cyn d 1 with mature proteins of 244 amino acid residues. A 97-99% identity was found among the deduced amino acids of these four clones while an 86% identity was elicited between the four clones and the ones previously identified. The predicted isoelectric focusing (pI) values of the newly identified Cyn d 1s are acidic while pIs of the previously identified Cyn d 1s are basic. The two recombinant acidic Cyn d 1 proteins possess the epitopes recognized by mouse and rabbit polyclonal anti-Cyn d 1 antibodies, and have human IgE-binding capacity as revealed by immunodot assay.

CONCLUSIONS

The present study identified full-length cDNAs encoding new isoallergens of Cyn d 1, and separated Cyn d 1 gene into an acidic group and a basic group.

Disinfection of hospital waste sludge using hypochlorite and chlorine dioxide

Hypochlorite and chlorine dioxide were used to disinfect hospital waste-water sludge. Their abilities to inactivate pathogenic micro-organisms were compared. Reductions in indigenous coliform organisms and Pseudomonas aeruginosa were estimated. The results indicate that hypochlorite is a better disinfectant than chlorine dioxide for coliforms. Higher disinfection efficiency was obtained by treating a lower concentration of sludge. In addition, a higher agitation speed gave a higher disinfection efficiency with hypochlorite. The disinfection efficiencies of both disinfectants were higher against settled sludge than against thickened sludge. Therefore, it is recommended that disinfection should be performed on settled sludge rather than in a thickening tank.

[Stress and dietary salt intake in the pathogenesis of hypertension: role of the renal and sympathetic nervous system]

Using the methods of electrophysiology, biochemistry, radioimmunoassay, and electron microscopy, changes of sympathetic nervous system and renal function in hypertensive SD rats induced by stress and high-salt intake were investigated. The results are as follows: (1) Renal plasma flow (RPF) and urinary sodium excretion obviously increased in salt-loading rats. Stress could result in marked reduction of RPF. (2) Electron micrography showed a dramatic increase in cell and mitochondrial volume in the proximal and distal convoluted tubules of high-salt diet rats. After stress of two weeks, the cells of the tubule became atrophic and mitochondrial volume decreased. (3) The same recovery from the declining renal cortical Na-K-ATPase activity in high-salt diet rats could be observed by maintained stress. (4) Low frequency (0.2-0.9 Hz) of BP variability was higher in stress rats as compared to control. (5) Both plasma renin activity (PRA) and angiotensin II (ANG II) levels increased in stress rats, but the decrease in high-salt diet rats gradually reached the high level of the former in two weeks. (6) Increase of BP, fall in RPF, or augment in PRA and ANG II were not observed in stress rats subjected to bilateral renal denervation. The above results indicate that the renal mechanism mediated by increased renal sympathetic nervous system plays an important role in stress- and salt-induced hypertension pathogenesis.

Quantification of pathogenic micro-organisms in the sludge from treated hospital wastewater

The sludge from hospital waste treatment facilities is a potential source of infectious organisms. The average numbers of micro-organisms in the sludge of hospital wastewater in Taiwan were as follows: total count 8.1 x 10(7) cfu g-1 (dry weight of sludge), and 1.4 x 10(6), 3.6 x 10(5), 1.6 x 10(5), 2.2 x 10(5) and 5.5 x 10(4) cfu g-1 (dry weight of sludge) for total coliforms, faecal coliforms, faecal streptococci, Pseudomonas aeruginosa and Salmonella spp., respectively. Salmonella spp. were detected in 37% (10 of 27) of the sludges from hospital wastewaters. Therefore, the treatment of such sludge to reduce pathogenic micro-organisms should be considered.

Low intensities and 1.3 ratio produce distortion product otoacoustic emissions which are larger in heterozygous (+/dn) than homozygous (+/+) mice

The f2/f1 frequency ratio of 1.3 in combination with stimulus levels of L1/L2 = 50/60 and 50/50 dB SPL produced a higher level of distortion product otoacoustic emissions (DPOAE) in the heterozygous (+/dn) mice than in the homozygous (+/+) mice. These results suggest that the dn gene carriers have a unique cochlear trait which may be related to the dn gene locus and expressed via a frequency- and intensity-dependent DPOAE function.

A case of Morgagni hernia presenting as pneumonia

Morgagni-type diaphragmatic hernias are rare. The overwhelming majority are discovered in children who usually present with pneumonia or sepsis. We report an unusual case of a 57-yr-old woman with a Morgagni hernia presenting with pulmonary symptoms. Complicating the clinical picture, the pneumonia delayed the definitive diagnosis until a lateral chest X-ray study revealed loops of bowel in the right lower lung fields. It is important to entertain abdominal etiologies in the differential diagnosis of a thoracic density.

Modulatory effects of polycyclic aromatic hydrocarbons on the mutagenicity of 1-nitropyrene: a structure-activity relationship study

Benzo[a]pyrene (B[a]P) is able to inhibit the mutagenicity of 1-nitropyrene (1-NP) through the reduction of nitroreductase activity and formation of adducts with DNA. The relationships between the chemical structure of 9 polycyclic aromatic hydrocarbons (PAHs) and antagonistic effects on the 1-NP-induced mutation were evaluated by the binary mixtures of 1-NP and PAHs with Salmonella typhimurium TA98 in the absence of S9 mix. Remarkably different antagonistic effects of 9 PAHs on the mutagenicity of 1-NP were observed. Among the tested PAHs, coronene demonstrates the most antagonistic potential followed by benzo[g,h,i]perylene (B[g,h,i]P), benzo[e]pyrene (B[e]P), dibenzo[a,h]pyrene (DB[a,h]P), benzo[a]pyrene (B[a]P) and pyrene. Naphthalene, anthracene, and chrysene had only minor inhibitory activity on the 1-NP mutagenicity. The modifying effects of PAHs on the nitroreductase activity of TA98 strains in the presence of 1-NP were further examined from the production of 1-AP. The statistical analytical data showed that the inhibitory effect of PAHs on the mutagenicity of 1-NP significantly correlated with their effects on the nitroreductase activity (r = -0.69, p < 0.05). In addition, the formation of 1-NP-DNA adducts of the binary mixtures of 1-NP and PAH was determined by the 32P-postlabeling method. The results indicated that the modulatory effects of PAHs on the formation of 1-NP-DNA adducts were correlated well with their antagonistic activity (r = -0.91, P < 0.01). From the above results, the relationships between the chemical structure of PAHs and the antagonistic effects on the 1-NP mutagenicity were revealed by the surface area and electronic parameters of PAHs. The planar molecular area of PAHs was more convincingly correlated with the antagonistic effect on the mutagenicity of 1-NP (r = -0.81, p < 0.01) than that with the difference in energy, delta E, between EHOMO and ELUMO (r = 0.69, p < 0.05). According to the above, two possible mechanisms are involved in the interactive effect of the binary mixtures: (1) a higher binding affinity with nitroreductase for PAHs having a large planar surface area; and (2) a high energy of interaction between 1-NP and PAHs with a low delta E might decrease the nitroreductive capability.

Congenital muscular dystrophy: report of one case

A case is reported of a newborn who presented with generalized hypotonia shortly after delivery. Creatine kinase (CK) was highly elevated. Muscle biopsy of the rectus femoris muscle revealed varying sized muscle fibers, displacement by fat and connective tissues, necrosis and regeneration of the muscle fibers. Magnetic resonance imaging (M.R.I.) of the brain showed normal development, compatible with the patient's age. Congenital muscular dystrophy was diagnosed from clinical manifestations, laboratory findings, and the results of muscle biopsy.

Unexplained gradual-onset Q wave patterns. A case series from the Framingham Study

Original cohort members of the Framingham Study were studied to determine prognosis associated with unexplained (gradual-onset) Q wave patterns detected on routine electrocardiograms (ECGs). Biennial ECGs were obtained on subjects beginning in 1948. The index ECG was read independently and then serially in relation to all previous tracings for evidence of myocardial infarction. Proportional hazards modeling was used to assess the risk for outcomes in those with unexplained (gradual-onset) Q wave patterns compared with subjects with unrecognized myocardial infarcts (abrupt-onset Q waves) and compared with referent subjects. Unexplained Q wave patterns developed in 53 men and 39 women. Subjects with unexplained Q wave patterns had less than 40% of the risk for myocardial infarction or coronary death as compared with those with unrecognized myocardial infarction after adjusting for risk factors (hazard ratio, 0.38; 95% confidence interval, 0.19, 0.78; P = .008) and a trend toward a lower risk for overall mortality (adjusted hazard ratio, 0.73; 95% confidence interval, 0.46, 1.16; P = .18). Risks for myocardial infarction or coronary death and overall mortality were similar in subjects with unexplained Q wave patterns and referent subjects in the fully adjusted models. Detection of prominent Q waves on an ECG requires comparison with prior tracings to differentiate the unexplained Q wave pattern from the unrecognized infarct, conditions that have significantly different prognostic implications.

The effect of recombinant human erythropoietin in treating the anemia of prematurity

Anemia of prematurity (AOP) has been conventionally treated with erythrocyte transfusions. Recent investigations have reported the use of recombinant human erythropoietin (rHuEPO) as an alternative for treating AOP. The potential of rHuEPO in increasing erythropoiesis implies its clinical usefulness. The effect of rHuEPO on reticulocyte count as well as other parameters of blood cells was examined in 14 premature babies with AOP. The average birth body weight and gestational age of these premature babies were 1533.71 +/- 61.66 g (Mean +/- SEM) and 31.36 +/- 0.49 weeks respectively. They received the first dose of rHuEPO at age 26.14 +/- 2.03 days with a hemoglobin level by 9.40 +/- 0.27 g/dL and hematocrit level of 28.20 +/- 0.81%. They were given rHuEPO 200 U/kg subcutaneously every other day for 10 doses, and iron 3 mg/kg and vitamin E 25 IU/kg per os every day. Average erythropoietin level of the patients on entry into this study was low (7.66 +/- 1.10 mu/mL). After treatment with rHuEPO for 20 days, the corrected reticulocyte count increased from 0.64 +/- 0.10% to 1.68 +/- 0.42% on Day 5 (P < 0.05), 1.96 +/- 0.41% on Day 12 (P < 0.05), 1.77 +/- 0.43% on Day 20 (P < 0.05), and hematocrit increased from 28.2 +/- 0.81% to 29.58 +/- 1.02% (p < 0.05) on Day 20. Bone marrow aspirates on Day 10 for 9 infants revealed moderate to high cellularity, mostly with erythroblasts (47.89 +/- 1.78%); the M/E ratio was low (0.57 +/- 0.05). The granulocyte series and megakaryocyte could be well visualised.(ABSTRACT TRUNCATED AT 250 WORDS)

Intestinal volvulus caused by a persistent omphalomesenteric band: report of one case

Persistent omphalomesenteric band is a rare cause of volvulus or intestinal obstruction. A 7-month-old male infant was brought to this Emergency Room after having shown poor appetite for three days, frequent bilious vomiting, and fever for half a day. Physical examination revealed the infant was dehydrated and had slight abdominal distension as well as hypoactive bowel sounds with a tender, ill-defined mass over right lower quadrant. Radiography and sonography were consistent with distal small bowel obstruction. Emergent laparotomy was done and a fibrous band found extending from the anti-mesenteric border of the ileum to the posterior wall of the umbilicus. Small bowel volvulus had occurred around the band and dilated small bowel was noted. An understanding of the embryologic development of these structures and their normal disappearance may assist pediatricians and surgeons to make the correct diagnosis and select the right pathoanatomic approach in surgery.

Development of bioabsorbable glass fibres

Calcium-iron phosphate glasses with an iron oxide content ranging from 5 wt.% to 22 wt.% were prepared to investigate the effect of iron oxide on the properties of the glass. It was found that the dissolution rate, the fibre strength and the glass transition temperature were strongly affected by iron oxide. The glass dissolution rate exhibited a 50-fold reduction while the fibre strength doubled when the iron oxide content was increased from 5 wt.% to 22 wt.%. The phosphate glass containing 22 wt.% of iron oxide had a dissolution rate of about 5 micrograms/(cm2 day). The fibres drawn from this glass also exhibited the highest tensile strength over 1000 MPa. A cortical bone plug method was used to assess the biocompatibility of the glasses with the hard and soft tissues. The tissues surrounding the samples showed no inflammation at 9 wk.

Characterization of the mutagen 2-amino-3-methylimidazo[4,5-f]quinoline prepared from a 2-methylpyridine/creatinine/acetylformaldehyde model system

A mixture of 2-methylpyridine, creatinine and aldehydes was heated in diethylene glycol containing 5% water for 1 h at 140 degrees C. The mutagenic compounds were purified by XAD-2 column chromatography, acid/base partition, blue cotton treatment, thin layer chromatography and HPLC. The active substances purified from each step were monitored by their mutagenicity with Salmonella typhimurium TA98 in the presence of S9 mix. Among the mutagens collected, 2-amino-3-methylimidazo[4,5-f]quinoline (IQ) was isolated from HPLC, and was identified by its UV and mass spectrum using a photodiode array detector and mass spectrometry. Our findings appear to be the first experimental evidence to substantiate the hypothetical pathway for the formation of IQ mutagens from a heated model system consisting of a pyridine or pyrazine derivative, an aldehyde and creatinine or creatine.

Transient myeloproliferative disorder and acute myeloid leukemia: study of six neonatal cases with long-term follow-up

Six neonates with hematological and clinical pictures indistinguishable from acute myeloid leukemia were studied. Two patients had Down syndrome and three others had either +21 or i(21q) chromosomal abnormalities in their blood cells at presentation. Granulocyte-macrophage colony-forming unit assays performed in bone marrow and peripheral blood mononuclear cells revealed abnormal growth patterns in two patients; both died of progressive disease of acute myeloid leukemia. All the other four neonates with normal in vitro cell growth pattern had spontaneous remission within 7 months. Of these four patients, one remains well and in remission for 8 years and the other three developed acute myeloid leukemia at the ages of 15, 32 and 19 months, respectively. We conclude that the in vitro cell growth pattern is helpful to distinguish transient myeloproliferative disorder from congenital acute myeloid leukemia and that patients with the former condition are at risk to develop acute myeloid leukemia subsequently.

Health status of patients with childhood acute lymphoblastic leukemia in continuous complete remission for over five years. The Taiwan Children's Cancer Study Group

Ninety-seven patients with childhood acute lymphoblastic leukemia (ALL) have achieved complete continuous first remission for more than five years. They were treated by Taiwan Children's Cancer Study Group protocol 821 or protocol 842. Their present health status was evaluated using blood counts, immunology, a psychiatric analysis and growth parameters. Hemoglobin and platelet counts rose quickly to the normal range after complete remission was achieved, then remained at low normal throughout the course. The leukocyte counts responded immediately to chemotherapy, usually recovering to about 5,000/uL, then gradually increasing after completion of chemotherapy. The absolute neutrophil counts were at a low normal level during chemotherapy, then gradually recovered to the normal level after chemotherapy was completed. Immunologic investigation after completion of chemotherapy showed that the subsets of lymphocytes were nearly all in the normal range for the 38 patients tested. On the other hand, in 17 patients tested for T-cell function, it was found that 29.4% had low natural killer (NK) cell cytotoxicity, 11.8% had an abnormal phytohemagglutinin (PHA) test and all had abnormally low IL-2 production (in vitro). There were 29 patients who had psychiatric analyses; the full IQ was borderline in 10.3%. The primary or middle school academic scores of 55 patients were reported; 15% of them belonged to the lower one-third of the class. Height was assessed by the standard deviation score from the mean for 58 patients. The differences were statistically insignificant; however, there were six patients whose growth curves crossed over their initial percentile line.(ABSTRACT TRUNCATED AT 250 WORDS)

Leigh disease (subacute necrotizing encephalomyelopathy): report of one case

A case is reported of a 16-month-old girl who presented with generalized hypotonia, ptosis and persistent low grade fever after a previous pneumonia. Brain CT and MRI showed symmetric necrotizing lesions in the basal ganglia, substantia nigra and periaqueduct area. Lactate and pyruvate levels were elevated in both the blood and cerebrospinal fluid. Biopsy of the rectus femoris muscle for electron microscopic examination revealed some distortion of the mitochondrial cristae. Biochemical study showed normal respiratory chain enzymes. Leigh disease was considered from the neuroradiological findings and morphological investigations.

Treatment of childhood acute lymphoblastic leukemia with protocol TCL-842 in Taiwan: the Taiwan Children's Cancer Study Group

From March 1984 to May 1988, 212 children with acute lymphoblastic leukemia were enrolled on Protocol TCL-842. In all, 68 patients were classified as standard risk (SR), 56 as intermediate risk (IR), and 88 as high risk (HR) groups. Remission induction for all three groups consisted of vincristine (VCR), prednisolone (PRED) and L-asparaginase (L-Asp). One consolidation course with cyclophosphamide (CP) and cytarabine (AraC) was used for the SR and IR groups, and two courses were given to patients in the HR group. Central nervous system prophylaxis was randomized using either cranial irradiation 18 Gy + 5 intrathecal methotrexate (IT MTX) or triple IT with maintenance. Reinforcement cycles were employed periodically during maintenance therapy (basically 6-mercaptopurine+MTX) and varied among the three groups. Four-week oral PRED every 16 weeks was the sole reinforcement agent for SR. Two-week VCR+dexamethasone (DEX)+adriamycin CP cycles were used to reinforce IR and HR at different intervals. Five third-form cycles with VCR+DEX+AraC were used only for HR. Treatment was discontinued after three years in patients who achieved continuous complete remissions (CCR). Eight patients died during the induction phase and eight failed to achieve complete remission (CR). The CR rate for SR was 97%, for IR was 98% and for HR was 83.3%; the overall rate was 91.8%. As of 30 June 1991, 33 patients had dropped out, 12 had died during remission, and 52 had relapsed. Twenty-eight SR, 26 IR, and 29 HR patients remained in CCR with a median follow-up duration of 66 months (38-88 months).(ABSTRACT TRUNCATED AT 250 WORDS)