Evaluation of staging conformity CTNM and PTNM for lung cancer

A series of 225 consecutive lung cancer patients were prospectively randomized into study group (75 patients) and control group (150 patients), and the conformity of CTNM and PTNM staging was was evaluated. Radical mediastinal lymph node dissection was performed and in average 11.5 nodes were dissected in the study group. Only suspected metastatic lymph nodes, 3.4 in average, were dissected in the control group. CTNM classification was made according to clinical examination, chest image examination and bronchoscopy in every patient and PTNM staging was made after thoracotomy. Then the conformity of CTNM and PTNM staging was examined by Kappa value. The results showed that the Kappa value in the two groups was lower than the effective standard value of 0.4. The study group (Kappa = 0.097) was poorer than the control group (Kappa = 0.371). The principal influencing cause was that N was not well evaluated by CTNM. The principal manifestation of the staging inconsistency was that the stage of PTNM was advanced than that of CTNM. In the study group 43% of patients showed an increased stage and this occurred in 33% of the control group (P < 0.05). The results of the study show that at present the CTNM staging has not fully satisfied the needs of practice and requires to be further improved. The operative procedure which only dissects suspected involved mediastinal lymph nodes can not meet the needs of PTNM staging. In order to make PTNM staging accurately and evaluate the results of treatment for lung cancer, radical mediastinal lymph node dissection should be performed in every operable patient.     

The vacB gene required for virulence in Shigella flexneri and Escherichia coli encodes the exoribonuclease RNase R

vacB, a gene previously shown to be required for expression of virulence in Shigella and enteroinvasive Escherichia coli, has been found to encode the 3'-5' exoribonuclease, RNase R. Thus, cloning of E. coli vacB led to overexpression of RNase R activity, and partial deletion or interruption of the cloned gene abolished this overexpression. Interruption of the chromosomal copy of vacB eliminated endogenous RNase R activity; however, the absence of RNase R by itself had no effect on cell growth. In contrast, cells lacking both RNase R and polynucleotide phosphorylase were found to be inviable. These data indicate that RNase R participates in an essential cell function in addition to its role in virulence. The identification of the vacB gene product as RNase R should aid in understanding how the virulence phenotype in enterobacteria is expressed and regulated. On the basis of this information we propose that vacB be renamed rnr.     

Immunization against rabies with plant-derived antigen

We previously demonstrated that recombinant plant virus particles containing a chimeric peptide representing two rabies virus epitopes stimulate virus neutralizing antibody synthesis in immunized mice. We show here that mice immunized intraperitoneally or orally (by gastric intubation or by feeding on virus-infected spinach leaves) with engineered plant virus particles containing rabies antigen mount a local and systemic immune response. After the third dose of antigen, given intraperitoneally, 40% of the mice were protected against challenge infection with a lethal dose of rabies virus. Oral administration of the antigen stimulated serum IgG and IgA synthesis and ameliorated the clinical signs caused by intranasal infection with an attenuated rabies virus strain.     

Accommodative esotropia during the first year of life

Two infants developed accommodative esotropia during their first six months of life. One infant, whose age at onset was 4 1/2 months, had 4.50 diopters of hyperopia. The second infant, whose age at onset was 5 months, had 3.50 diopters of hyperopia. In both infants, the eyes completely aligned with hyperopic correction. Two points are stressed. First, when the amount of hyperopia exceeds +3.00, consideration should be given to an accommodative element as the cause of the esotropia, even if the child is only 4 to 6 months old. Second, even with small angles of esotropia, an accommodative element should be considered, if there is a substantial amount of hyperopia.