Prognostic factors of primary liver cancer

To investigate the prognostic factors of primary liver cancer (PLC) and improve the long-term results, 1,248 cases of PLC were analysed. Univariate analysis demonstrated that discovery approach, staging of PLC, original gamma-GPT, resection, radical resection, original AFP, tumor size, tumor number, and tumor capsule have very significant effects on prognosis of PLC (all P < 0.001); cirrhosis, HBsAg, local resection, and tumor embolus in portal vein were also significant difference (all P < 0.05); age, sex, original AFP, hepatitis, and differentiation of PLC cells were no significant difference (all P > 0.05). Multivariate analysis demonstrated that original gamma-GPT, radical resection, tumor size, and tumor number were the most significant prognostic factors (all P < 0.001). Some aspects improving long-term survival were discussed.     

Three-node, 40 Gbit/s OTDM network experiment using electro-opticswitches

The authors demonstrate, for the first time, a three node optically time division multiplexed network with a maximum capacity of 40 Gbit/s. Electro-optical switches were used for both `drop and insert' and demultiplexing, and electronic clock recovery provided synchronisation throughout the network     

High-Pressure (up to 140 MPa) Dynamic Viscosity of the Methane and Toluene System: Measurements and Comparative Study of Some Representative Models

The dynamic viscosity of toluene and methane mixtures containing 25.03, 37.19, 49.95, 64.11, and 95.00 mol% methane has been measured using a falling-body viscometer. The measurements (280 data points) have been performed in the temperature range 293.15 to 373.15 K and at pressures up to 140 MPa. The data have been discussed in the framework of recent representative models (hard-sphere scheme, friction theory, and free-volume model) as well as with simple mixing laws and empirical models (particularly the LBC model and the self-referencing model) used in the literature. This comparative study shows that the average absolute deviation of the models is between 4.9 and 26.8%, and the maximum deviation is between 11.6 and 49.5%.     

Fluidised pellet bed bioreactor: a promising technology for onsite wastewater treatment and reuse.

A pilot-scale fluidised pellet bed (FPB) bioreactor, which combines chemical coagulation, biological degradation, particle pelletisation and separation in one unit, was applied for onsite wastewater treatment and reuse. As a result of rational use of inorganic coagulant and organic polymer and moderate mechanical agitation, spherical particles were generated in the upflow column and a well-fluidised bed was formed. With a continuous supply of dissolved oxygen through a recycling loop, an aerobic condition was kept in the bottom section of the FPB column. Under such conditions the pellets in the FPB column showed the following characteristics: (1) compact structure and high density; (2) rich in microorganisms; and (3) high MLSS and MLVSS concentrations. Therefore, the FPB bioreactor achieved more than 90% removal of SS, COD, BOD and TP from raw domestic wastewater within a total hydraulic retention time (HRT) of only about 30 minutes. It also showed nitrification and denitrification ability and the TN removal could be about 50% as the recycling ratio was increased to 1:1. The treated water quality is generally competitive with the secondary effluent from a conventional activated sludge process. With these advantages the FPB bioreactor is recommendable as a compact system for onsite wastewater treatment and reuse.     

Thrombopoietic factors potentially useful in the treatment of acute leukemia

Thrombocytopenia is a major cause of morbidity following intensive chemotherapy for acute leukemia. Over recent years, there has been an increasing use of platelet transfusions which, although generally efficacious to prevent severe hemorrhage, have associated risks of transmitting blood-borne disease and of alloimmunization. Therefore, there is a clinical requirement for a drug that will reliably alleviate the thrombocytopenia associated with leukemia therapy. The c-mpl ligand thrombopoietin is the most interesting factor for the treatment of thrombocytopenia because of its lineage specificity. Phase I and II studies confirm its biological efficacy to induce rise in platelet count in patients with solid tumors and acute leukemia. Several other pleiotropic hematopoietic growth factors are also currently in clinical trials. These include interleukin-6, interleukin-3, interleukin-11, PIXY321 and stem cell factor. The effects of these cytokines appear to be modest at most and, with the exception of interleukin-11, their side effects are likely to limit their clinical application. Combinations of factors may prove more efficacious approaches to enhance platelet recovery.     

La?nnec, re-inventor of the stethoscope?

According to our common medical culture, some facts are simply unquestionable, for instance La?nnec invented the stethoscope. But was he the first one? On a recent trip to Egypt we visited the temple of Kom Ombo, built prior to the roman period and renowned as a medical care center. Today, the tourist is fascinated by the magnificent hieroglyphics on the well-preserved walls testifying to significant advances in various fields of medicine including ophthalmology and gynecology. We were particularly interested by the basreliefs presenting vivid drawings of some of the first medical instruments. We easily identified curettes, scissors, a balance, forceps for dental extraction, and a surgical saw, but were captivated by two other instruments. The first one looked a lot like what La?nnec invented around 1820. The second one was amazingly similar to the instrument we use everyday, with a distal opening and flexible tubes (woven papyrus?) leading to proximal ear pieces. Our Egyptian guide was formal: the stethoscope was invented in Egypt. The scientific impact of our observations leaves something to be desired, but did make us think about the huge gap between the advancement of medical knowledge in ancient Egypt and La?nnec's (re)-invention. Exposed to a similar gap in history, what would our documents stored on CD and video tapes have to say to future touring doctors?     

Conformational stability of factor VIIa: biophysical studies of thermal and guanidine hydrochloride-induced denaturation

The binding of the multidomain protein factor VIIa (fVIIa) to tissue factor provides the interprotein communication necessary to make fVIIa an efficient catalyst of the initial event in the extrinsic pathway of blood coagulation. We have investigated the stability of individual domains in fVIIa and the influence of Ca2+ and an irreversible active-site inhibitor (FFR-chloromethyl ketone). Equilibrium guanidine hydrochloride (GuHCl)-induced unfolding monitored by tryptophan fluorescence and far-UV circular dichroism (CD) demonstrated that the gamma-carboxyglutamic acid (Gla) domain unfolds at 0.3 M GuHCl and the serine protease (SP) domain at 3 M GuHCl and that Ca2+ is a prerequisite for the formation of an ordered, compact structure in the Gla domain. The loss of amidolytic activity coincides with the first transition, which is stabilized by the active-site inhibitor, and a change in the environment of the active site is demonstrated using a fluorescent inhibitor (DEGR-chloromethyl ketone). Thermal unfolding monitored by differential scanning calorimetry (DSC) reveals that Ca2+ stabilizes the SP domain slightly, increasing the unfolding temperature by 2.7 degrees C. In addition, Ca2+ is required for a large enthalpy change concomitant with unfolding of the Gla domain, and this unfolding enthalpy is only detectable in the presence of the SP domain, indicating some kind of interaction between these domains. Thermal unfolding measured by CD indicates secondary structural changes at the same temperature as the heat absorption in the DSC but only when both the Gla domain and the SP domain are present together with Ca2+ ions. Taken together, these results indicate a Ca2+-dependent interaction between the Gla domain and the SP domain, implying a high degree of flexibility of the domains in free fVIIa. It is also shown that the epidermal growth factor-like domains are stable at elevated temperatures and high GuHCl concentrations. Moreover, already at physiological temperature, subtle structural changes take place which influence the overall shape of fVIIa and are detrimental to its enzymatic activity.     

CTLA4 mediates antigen-specific apoptosis of human T cells

The regulation of T cell-mediated immune responses requires a balance between amplification and generation of effector function and subsequent selective termination by clonal deletion. Although apoptosis of previously activated T cells can be induced by signaling of the tumor necrosis factor receptor family, these molecules do not appear to regulate T-cell clonal deletion in an antigen-specific fashion. We demonstrate that cross-linking of the inducible T-cell surface molecule CTLA4 can mediate apoptosis of previously activated human T lymphocytes. This function appears to be antigen-restricted, since a concomitant signal T-cell receptor signal is required. Regulation of this pathway may provide a novel therapeutic strategy to delete antigen-specific activated T cells.