Functional neuroanatomy of the basal ganglia as studied by dual-probe microdialysis

This is a report of two cases of mature mediastinal teratoma associated with elevated serum SCC levels. The first patient was a 17-year-old female admitted to our hospital for severe left chest pain. Chest x-ray film and CT scan showed a mediastinal tumor. The preoperative serum SCC level was elevated. Resection was performed and the pathological diagnosis was mature teratoma. The second patient was a 32-year-old male admitted to our hospital for severe anterior chest pain. A chest CT scan showed a mediastinal tumor. The preoperative serum SCC level was high. Surgery was performed and the pathological diagnosis was mature teratoma. The cause of the high serum SCC levels was unclear, but we suspect that the pulmonary atelectasis may have caused it.     

Assessment of factors affecting palpability of breast masses using ultrasonography in Chinese women

Five hundred and twenty-nine women with self-discovered or clinically palpable breast lumps had physical examination followed by high-resolution ultrasonographic examination of the breast. A total of 482 palpable and 146 nonpalpable masses were discovered by ultrasonography. The median values of the breast stromal, premammary, and retromammary fat thickness measurements were 1.3 cm, 0.1 cm, and 0.1 cm, respectively. The median depths of the lesions and the distance of the lesions from the pectoralis muscle were 0.5 cm and 0.2 cm, respectively. The median size of all breast masses was 1.5 cm. These measurements (of the tissue characteristics of the breast, location of the breast mass, and size of the breast lesion) were correlated with palpability or nonpalpability of the breast lesions. Multivariate logistic regression performed for all breast masses showed the only significant factors affecting palpability to be the size (anteroposterior and transverse diameters) and the depth of a breast mass. This is expressed by the following equation: [formula: see text] where z = -0.8759 + 0.9691 (g) + 2.2770 (e)-1.5332 (d), and d represents depth of lesion from the cutaneous surface and e and g represent anteroposterior and transverse diameters of the breast mass, respectively. The nature of the breast tissue (i.e., the premammary fat, retromammary fat, or breast stromal thickness as determined by ultrasonography) does not affect palpability. This study would therefore strongly support the recommendation of breast self-examination, irrespective of breast structure.     

Dexmedetomidine and halothane produce similar alterations in electroencephalographic and electromyographic activity in cats

Hydroxylated polychlorinated biphenyls also known as biphenylols, are suspected estrogen mimics found in the environment. Various derivatization schemes were evaluated and a gas chromatography-ion trap mass spectrometry method was developed for the trifluoroacetyl derivative using MS-MS techniques for the analysis of eleven biphenylols. A time-segmented chromatographic method was developed using the respective MS-MS parameters to analyze all the eleven biphenylols in a single chromatographic run. Isomers were differentiated based on the MS-MS data of the trofluoroacetyl-biphenylol derivatives. The method was applied to detect 40 pg on-column of these compounds in a spiked egg sample which simulates a real world sample.     

Combined oral positive inotropic and beta-blocker therapy for treatment of refractory class IV heart failure

OBJECTIVES: We sought to assess the effects of combined oral positive inotropic and beta-blocker therapy in patients with severe heart failure. BACKGROUND: Patients with severe, class IV heart failure who receive standard medical therapy exhibit a 1-year mortality rate >50%. Moreover, such patients generally do not tolerate beta-blockade, a promising new therapy for chronic heart failure. Positive inotropes, including phosphodiesterase inhibitors, are associated with increased mortality when administered over the long term in these patients. The addition of a beta-blocker to positive inotropic therapy might attenuate this adverse effect, although long-term oral inotropic therapy might serve as a bridge to beta-blockade. METHODS: Thirty patients with severe heart failure (left ventricular ejection fraction [LVEF] 17.2+/-1.2%, cardiac index 1.6+/-0.1 liter/min per m2) were treated with the combination of oral enoximone (a phosphodiesterase inhibitor) and oral metoprolol at two institutions. Enoximone was given at a dose of < or = 1 mg/kg body weight three times a day. After clinical stabilization, metoprolol was initiated at 6.25 mg twice a day and slowly titrated up to a target dose of 100 to 200 mg/day. RESULTS: Ninety-six percent of the patients tolerated enoximone, whereas 80% tolerated the addition of metoprolol. The mean duration of combination therapy was 9.4+/-1.8 months. The mean length of follow-up was 20.9+/-3.9 months. Of the 23 patients receiving the combination therapy, 48% were weaned off enoximone over the long term. The LVEF increased significantly, from 17.7+/-1.6% to 27.6+/-3.4% (p=0.01), whereas the New York Heart Association functional class improved from 4+/-0 to 2.8+/-0.1 (p=0.0001). The number of hospital admissions tended to decrease during therapy (p=0.06). The estimated probability of survival at 1 year was 81+/-9%. Heart transplantation was performed successfully in nine patients (30%). CONCLUSIONS: Combination therapy with a positive inotrope and a beta-blocker appears to be useful in the treatment of severe, class IV heart failure. It may be used as a palliative measure when transplantation is not an option or as a bridge to heart transplantation. Further study of this form of combined therapy is warranted.     

Cloning of Rab GTPases expressed in human skeletal muscle: studies in insulin-resistant subjects

To explore the potential role of Rab GTPases in human insulin resistance, we first employed a PCR-cloning approach to identify Rab isoforms that are expressed in human skeletal muscle. Multiple Rab isoforms including Rab1A, Rab4A, Rab5B, Rab7, Rab8, Rab10, Rab12A, Rab13, Rab18, Rab21, and Rab22 mRNA were found to be expressed in human skeletal muscle. The second goal was to examine whether mRNA expression for Rabs targeted to endocytotic/exocytotic compartments was altered as a function of insulin resistance. Quantitative PCR analysis demonstrated that Rab4A, Rab5B and Rab18 mRNA levels in skeletal muscle from insulin-resistant patients without (IR) and with non-insulin-dependent diabetes mellitus (NIDDM) were not significantly different from those in insulin-sensitive controls (IS). At the protein level, total Rab5B amount was not significantly different among IS, IR and NIDDM subgroups. However, in basal muscle, Rab5B in the total membrane fraction was 2.1-3.6 fold higher in IR and NIDDM than in IS subjects. Insulin increased membrane-associated Rab5B by 3-fold in IS subjects, whereas this effect was not significant in both IR and NIDDM subgroups. Thus, for the first time, we have comprehensively studied the mRNA expression of Rab isoforms in human muscle. The phlethora of Rab GTPases are indicative of high volume of vesicular traffic and regulated metabolism. The potential role of specific Rab isoforms in insulin resistance does not rely on a change in steady state mRNA levels, but is demonstrable as an alteration in protein subcellular distribution and trafficking.     

Breast-conserving surgery and radiotherapy for early breast cancer

Breast conservation is not a commonly prescribed treatment option for breast cancer in Taiwan. We report 42 patients with 43 early-stage breast cancers who were treated with breast-conserving surgery and radiotherapy at the Koo Foundation Sun Yat-Sen Cancer Center from April 1990 to December 1994. Included in this study were 33 patients with stage I cancers and 10 with stage II. Breast-conserving surgery consisted of wide local excision and ipsilateral axillary lymph node dissection. Radiotherapy was given 2 to 6 weeks after surgery, with a dose of 46 to 50 Gy, 2 Gy per fraction per day, to the whole breast, and an additional 14 to 18 Gy to the original tumor site. Irradiation to the regional lymph nodes was not performed in patients with negative axillary lymph nodes. Sixteen out of 43 (37%) patients were treated with adjuvant chemotherapy. The local control rate 3 years after treatment was 97% and relapse-free survival was 91%. The cosmetic outcome in 41 treated breasts that were rendered relapse-free by conserving treatment were evaluated and graded by the physicians as excellent, good, fair or poor using a standardized scale. Forty breasts (98%) were scored as excellent or good for their cosmetic results. Breast-conserving surgery and radio-therapy offer Taiwanese women with early breast cancer excellent local control and a highly satisfactory cosmetic outcome.     

地空导弹武器装备经济寿命研究

分析了地空导弹武器装备的经济寿命，建立了地空导弹武器系统经济寿命评价的指标体系，在武器装备的寿命的基础上给出了武器装备经济寿命模型，实例证明该模型具有一定的使用价值。     

Growth characteristics of the aortic arch after the Norwood operation

OBJECTIVES: We sought to characterize the growth of the reconstructed aortic arch after the Norwood operation (NO). BACKGROUND: The first stage of surgical palliation of hypoplastic left heart syndrome (HLHS), the NO, includes augmentation of the aortic arch with homograft. Growth characteristics of the reconstructed aortic arch, which is comprised of both native aortic tissue and homograft, have not been characterized. METHODS: Retrospectively, we examined the serial echocardiograms of 50 patients with HLHS who underwent NO to determine the diameter of the reconstructed transverse arch. Measurements were taken immediately after NO and at two other points (1 to 11 years of age). In addition, the autopsy specimens of 10 other patients with HLHS who underwent NO were examined to determine the contribution of native aortic tissue to the overall size of the reconstructed arch at the time of death (12 to 34 months). RESULTS: The diameter of the transverse aorta increased after NO in all subjects. Its rate of growth paralleled that seen in the normal population, though the reconstructed arch had a significantly larger diameter throughout childhood. Examination of autopsy specimens demonstrated a mean increase in circumference of the native aortic tissue of 0.67 cm (p value <0.01), whereas there was no significant change in homograft circumference. CONCLUSIONS: After reconstruction of the aortic arch in HLHS, the diameter of the arch continues to increase throughout childhood, and this increase is due to growth of the native aortic tissue.