[Multi-omics combined test performance effectiveness on opportunistic screening of high-risk liver cancer population]

Objective: To validate the performance of a multi-omics combined test for early screening of high-risk liver cancer populations. Methods: 173 high-risk patients with liver cancer were prospectively screened in a real-world setting, and 164 cases were finally enrolled. B-ultrasound, alpha-fetoprotein (AFP), and HCC screens were conducted in all patients. A multi-omics early screening test was performed for liver cancer in combination with multi-gene methylation, TP53/TERT/CTNNB1 mutations, AFP, and abnormal prothrombin (PIVKA-II). Differences in rates were compared using the chi-square test, adjusted chi-square test, or Fisher's exact probability method for count data. A non-parametric rank test (Mann-Whitney) was used to compare the differences between the two groups of data. Results: The HCCscreen detection had a sensitivity of 100% for liver cancer screening, 93.8% for liver cancer and precancerous diseases, 34.1% for positive predictive value, 99.2% for negative predictive value, and 0.89 for an area under the curve (AUC). Parallel detection of AFP, AFP+B-ultrasound, and methylation+mutation had a sensitivity/specificity and AUC of 31.3%/88.5% (AUC=0.78), 56.3%/88.2% (AUC=0.86), and 81.3%/82.4 % (AUC=0.84). At the same time, the disease severity range was significantly correlated with the methylation+mutation score, HCCscreen score, or positive detection rate (PDR). There was no significant correlation between AFP serum levels and methylation+mutation or HCCscreen scores, while there was a significant linear correlation between methylation+mutation scores and HCCscreen scores (r = 0.73, P < 0.001). Conclusion: In real-world settings, HCCscreen shows high sensitivity for screening opportunistic, high-risk liver cancer populations. Furthermore, it may efficaciously detect liver cancer and precancerous diseases, with superior performance to AFP and AFP+ultrasound. Hence, HCCscreen has the potential to become an effective screening tool that is superior to existing screening methods for high-risk liver cancer populations.

[Summary of community smoking cessation intervention theory]

This paper analyzes the literatures about community-based smoking cessation interventions in recent decades and introduces the effectiveness of cessation interventions developed under different theoretical frameworks applied in the community. Because of the severe smoking prevalence in China and the shortage of existing smoking cessation services, the application of smoking cessation services in reducing the smoking rate in Chinese is discussed to provide a reference for the theoretical framework and practical application of community smoking cessation intervention research in China.

ID: 77: FAST-SKELETAL MYOSIN BINDING PROTEIN-C REGULATES SKELETAL MUSCLE CALCIUM SENSITIVITY

Mutations in myosin binding protein-C (MyBP-C) cause both cardiac and skeletal muscle diseases, such as hypertrophic cardiomyopathy and distal arthrogryposis. There are three isoforms of MyBP-C: slow-skeletal, fast-skeletal, and cardiac (ssMyBP-C, fsMyBP-C, and cMyBP-C, respectively). These isoforms reside within the sarcomere, the functional unit of muscle contraction at the molecular level. However, the function of the three major MyBP-C isoforms remains unclear. The present study is the first to focus on the least characterized isoform, fsMyBP-C, which is expressed in fast- and mixed-type skeletal muscles. To determine the necessity of fsMyBP-C for regulation of contraction in the sarcomere, we generated a conventional fast-skeletal MyBP-C knockout (FSKO) mouse model. We analyzed both structural changes and regulatory function of skeletal muscles from heterozygous (FSKO−/+) and homozygous (FSKO−/−), compared to wild-type (WT) mice. Neither heterozygous nor homozygous FSKO mice exhibited changes in morbidity or mortality relative to WT mice. Molecular analyses revealed a complete knockout of fsMyBP-C in the FSKO−/− skeletal muscles compared to FSKO−/+ and WT mice. Histopathological analyses of both Extensor digitorum longus (EDL) and soleus muscles revealed no obvious abnormalities, such as fibrosis or calcification, in either heterozygous or homozygous FSKO mice. Though fiber structure is preserved, we demonstrated that EDL muscles from FSKO−/− mice increases Ca2+-sensitivity of force development, suggesting that fsMyBP-C regulates contraction at the molecular level by decreasing Ca2+-sensitivity. While others have previously proposed the role of cMyBP-C is to increase Ca2+-sensitivity to normalize a Ca2+ gradient imbalance in the heart, we propose that the role of fsMyBP-C in skeletal muscles is to reduce Ca2+-sensitivity of the thin filaments in order to normalize the reversed Ca2+ gradient imbalance. Despite opposite effects on Ca2+-sensitivity, MyBP-C share the same functional role in both cardiac and skeletal muscles. Thus, in addition to elucidating the role of fast-skeletal MyBP-C and its regulation of skeletal muscle contraction, the present study provides insight into the cardiac isoform and its regulation of cardiac contraction.

Does surgery improve live birth rates in patients with recurrent miscarriage caused by uterine anomalies?

We found that congenital uterine anomalies have a negative impact on reproductive outcome in recurrent-miscarriage couples, being associated with further miscarriage with a normal embryonic karyotype. There has been no study comparing live birth rates between patients with and without surgery. We conducted a prospective study to prove that surgery for a bicornuate or septate uterus might improve the live birth rate. A total of 170 patients with congenital uterine anomalies suffering two or more miscarriages were examined. The live birth rate after ascertainment of anomalies, cumulative live birth rate and infertility rate, were compared between patients with and without surgery. In patients with a septate uterus, the live birth rate (81.3%) at the first pregnancy after ascertainment of anomalies with surgery tended to be higher than that (61.5%) in those without surgery. The infertility rates were similar in both groups, while the cumulative live birth rate (76.1%) tended to be higher than without surgery (60.0%). Surgery showed no benefit in patients with a bicornuate uterus for having a baby, but tended to decrease the preterm birth rate and the low birth weight. The possibility that surgery has benefits for having a baby in patients with a septate uterus suffering recurrent miscarriage could not be excluded.

Effects of freezing rates and cryoprotectant on thermal expansion of articular cartilage during freezing process

The intact articular cartilage has not yet been successfully preserved at low temperature most likely due to the volume expansion from water to ice during freezing. The objective of this current study focuses on examining thermal expansion behavior of articular cartilage (AC) during freezing from 0 degree C to -100 degree C. Thermo Mechanical Analysis (TMA) was used to investigate the effects of different concentrations of dimethyl sulphoxide (DMSO) (0%, 10%, 30% and 60% v/v) and different freezing rates (1 C/min, 3 C/min and 5 C/min). The results showed that: (1) the inhomogeneous thermal expansion (or contraction) presents due to inhomogeneous water distributions in articular cartilage during freezing, which also may be the most likely reason that the matrix has been damaged in cryopreserved intact articular cartilage; (2) at the phase transition temperature range, the maximum thermal strain change value for 5C/min is approximately 1.45 times than that for 1 C/min, but the maximum thermal expansion coefficient of the later is about six times than that of the former; (3) the thermal expansion coefficient decreases with increasing cooling rate at the unfrozen temperature region, but some opposite results are obtained at the frozen temperature region; (4) the higher the DMSO concentration is, at the phase change temperature region, the smaller the thermal strain change as well as the maximum thermal expansion coefficient are, but DMSO concentration exhibits little effect on the thermal expansion coefficient at both unfrozen and frozen region. Once the DMSO concentration increasing enough, e.g. 60% v/v, the thermal strain decreases linearly and smoothly without any abrupt change due to little or no ice crystal forms (i.e. vitrification) in frozen articular cartilage. This study may improve our understanding of the thermal expansion (or contraction) behavior of cryopreserved articular cartilage and it may be useful for the future study on cryopreservation of intact articular cartilage.

Down-regulation of iASPP in human hepatocellular carcinoma cells inhibits cell proliferation and tumor growth

The oncoprotein inhibitory member of the ASPP family (iASPP) is a key inhibitor of the p53 tumor suppressor and is upregulated in patients with acute leukemia and breast carcinoma. To investigate the effect of iASPP inhibition on the proliferation of hepatocellular carcinoma cells, a recombinant lentivirus vector expressing a small interfering RNA (siRNA) against iASPP gene expression was constructed and used to infect human hepatocellular carcinoma cells (HepG2 and Hep3B). The results showed that iASPP mRNA and protein levels were significantly down-regulated in both cells infected with the siRNA against iASPP. siRNA-mediated down-regulation of iASPP repressed tumor cell proliferation and colony formation in vitro and induced a growth delay of the tumor in vivo, suggesting that iASPP plays an important role in the proliferation of hepatocellular carcinoma cells. iASPP may be a valuable candidate target gene in hepatocellular carcinoma therapy.

Predictive Value of Serum-soluble CD154 in Fulminant Hepatic Failure

The interaction of CD40 with CD154 is a pivotal trigger of immune cascade-inducing acute liver failure, however its clinical significance has not been well studied. The present study aimed to investigate the clinical implications of serum-soluble CD154 (sCD154) levels and the expression of CD40 on monocytes in patients with fulminant hepatic failure (FHF). The results showed that serum sCD154 levels and CD40 expression on monocytes were significantly higher in FHF patients than in acute hepatitis (AH) patients and healthy controls, and were also significantly higher in FHF patients who died, compared with those who survived. We conclude that high serum levels of sCD154 may be linked to fatal outcome in patients with severe liver injury and may be a valuable prognostic marker for survival in patients with FHF.

Multimodal nonlinear spectral microscopy based on a femtosecond Cr:forsterite laser

We demonstrate a novel multimodal nonlinear spectral microscopy based on a femtosecond Cr:forsterite laser at 1230 nm. By acquiring the whole nonlinear spectrum in the visible and near-NIR region, this novel technique allows a combination of different imaging modalities, including second-harmonic generation, third-harmonic generation, and multiple-photon fluorescence. Combined with the selected excitation wavelength, which is located in the IR transparency window, this microscopic technique can provide high penetration depth with reduced damage and is ideal for studying living cells.

Early genes responsive to abscisic acid during heterophyllous induction in Marsilea quadrifolia

The aquatic fern Marsilea quadrifolia produces different types of leaves in response to changes in natural environment and culture conditions. When the conditions are in favor of producing the submerged-type leaves, exogenous application of the plant hormone abscisic acid (ABA) induces the formation of aerial-type leaves. Tissues responsive to ABA were localized to the shoot apical meristem and the associated organ primordia. From these tissues, at least two tiers of ABA-regulated early genes were identified, including seven primary genes and seventeen secondary genes. These genes, designated ABRH for ABA-responsive heterophylly, showed diverse expression patterns during the course of heterophyllous induction. Changes in the transcript level of ABRH genes started early, within 0.5-1.0 h after the addition of ABA to the culture medium. Some changes were transient while the others were persistent. The ABRHs contain extensive sequence homology to known genes, including those encoding transcription factors, protein kinases, membrane transporters, metabolic enzymes, structural proteins and those encoded by the chloroplast genome. Identification of these ABRHs is a first step toward the understanding of the regulation mechanisms of heterophylly, and the results suggest the involvement of novel metabolic and regulatory pathways in ABA-controlled morphogenesis.

Changes in myometrial thickness during hysteroscopic resection of deeply invasive submucous myomas

STUDY OBJECTIVE

To evaluate the efficacy of hysteroscopy in resecting submucous myomas with deep intramural invasion.

DESIGN

Prospective, observational study (Canadian Task Force classification II-2).

SETTING

Department of gynecology at a general hospital.

PATIENTS

Sixteen women with a solitary submucous myoma, in which myometrial thickness between the outer edge of the myoma and inner edge of the serosa was between 5 and 10 mm.

INTERVENTION

One-step hysteroscopic myomectomy.

MEASUREMENTS AND MAIN RESULTS

Median myoma diameter and weight were 3.3 cm and 30 g, respectively. Myometrial thickness between the myoma and serosa increased gradually and significantly from 6.7 mm before, to 8.9 mm during, to 16.1 mm immediately after hysteroscopic myomectomy (p <0.001). The thickness of the opposite uterine wall increased from 10.1 mm before, to 11.4 mm during, to 18.8 mm after operation (p <0.001).

CONCLUSION

One-step hysteroscopic myomectomy may be performed to remove deeply infiltrating submucous myomas when myometrial thickness at the implantation site is as thin as 5 mm.

Lateral root initiation in Marsilea quadrifolia. I. Origin and histogensis of lateral roots

In Marsilea quadrifolia, lateral roots arise from modified single cells of the endodermis located opposite the protoxylem poles within the meristematic region of the parent root. The initial cell divides in four specific planes to establish a five-celled lateral root primordium, with a tetrahedral apical cell in the centre and the oldest merophytes and the root cap along the sides. The cells of the merophyte divide in a precise pattern to give rise to the cells of the cortex, endodermis, pericycle, and vascular tissues of the emerging lateral root. Although the construction of the parent root is more complicated than that of lateral roots, patterns of cell division and tissue formation are similar in both types of roots, with the various tissues being arranged in similar positions in relation to the central axis. Vascular connection between the lateral root primordium and the parent root is derived from the pericycle cells lying between the former and the protoxylem members of the latter. It is proposed that the central axis of the root is not only a geometric centre, but also a physiological centre which determines the fate of the different cell types.

Multiphoton confocal microscopy using a femtosecond Cr:forsterite laser

With its output wavelength covering the infrared penetrating window of most biological tissues at 1,200-1,250 nm, the femtosecond Cr:forsterite laser shows high potential to serve as an excellent excitation source for the multiphoton fluorescence microscope. Its high output power, short optical pulse width, high stability, and low dispersion in fibers make it a perfect replacement for the currently widely used Ti:sapphire laser. In this paper, we study the capability of using a femtosecond Cr:forsterite laser in multiphoton scanning microscopy. We have performed the multiphoton excited photoluminescence spectrum measurement on several commonly used bioprobes using the 1,230 nm femtosecond pulses from a Cr:forsterite laser. Efficient fluorescence can be easily observed in these bioprobes through two-photon or three-photon excitation processes. These results will assist in the selection of dichroic beam splitter and band pass filters in a multiphoton microscopic system. We have also performed the autofluorescence spectrum measurement from chlorophylls in live leaves of the plant Arabidopsis thaliana excited by 1,230 nm femtosecond pulses from the Cr:forsterite laser. Bright luminescence from chlorophyll, centered at 673 and 728 nm, respectively, can be easily observed. Taking advantage of the bright two-photon photoluminescence from chlorophyll, we demonstrated the two-photon scanning paradermal and cross-sectional images of palisade mesophyll cells in live leaves of Arabidopsis thaliana.

Genomic analysis of the Hsp70 superfamily in Arabidopsis thaliana

The Arabidopsis genome contains at least 18 genes encoding members of the 70-kilodalton heat shock protein (Hsp70) family, 14 in the DnaK subfamily and 4 in the Hsp110/SSE subfamily. While the Hsp70s are highly conserved, a phylogenetic analysis including all members of this family in Arabidopsis and in yeast indicates the homology of Hsp70s in the subgroups, such as those predicted to localize in the same subcellular compartment and those similar to the mammalian Hsp110 and Grp170. Gene structure and genome organization suggest duplication in the origin of some genes. The Arabidopsis hsp70s exhibit distinct expression profiles; representative genes of the subgroups are expressed at relatively high levels during specific developmental stages and under thermal stress.

A modelling approach to global nitrate leaching caused by anthropogenic fertilisation

Water quality associated with nitrate (NO3-) leaching from agricultural soils is an important environmental issue. This paper describes a new modelling approach to quantitatively evaluate the effect of the use of fertilisers on global nitrate leaching. A global process-based simulation model was previously developed for the nitrogen cycle in terrestrial ecosystems, in which soil inorganic nitrogen in the form of ammonium (NH4+) and NO3- was considered. After introducing data on world fertiliser consumption (FAO, 1995) into the steady-state model, the extent of disturbance to the nitrogen cycle caused by fertilisation was calculated. Although fertilisation resulted in an annual increase in net primary production (NPP, represented as carbon) of 18 Gt year-1, NO3- leaching and gaseous losses of nitrogen oxides and ammonia were also accelerated. Most regions with heavy fertiliser application (over 100 kg ha-1 year-1) showed a high annual leaching load equal to or more than 20 kg ha-1 year-1. About 2.5% of the land area occupied by terrestrial ecosystems suffered a serious leaching load of more than 30 kg ha-1 year-1. Of the total amount of applied fertilisers (138 Tg year-1) 19% was lost to NO3- leaching, 8% to gaseous ammonia, and 3% to gaseous nitrogen oxides. The rest was assumed to be fixed in the ecosystems through vegetation uptake.

Heat shock protein (hsp 70)-related epitopes are common allergenic determinants for barley and corn antigens

IgE reactive components of barley and corn were compared using sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and immunoblotted with sera from workers exposed to complex bioaerosols. The antibody made against Arabdopsis heat shock protein (hsp 70) was used to identify those components equivalent to hsp 70 in molecular size. Components with a molecular mass of 69 kDa and 33 kDa were positively reacted, and immunoblots of two-dimensional polyacrylamide gel electrophoresis were compared.

Blue light and abscisic acid independently induce heterophyllous switch in marsilea quadrifolia

In natural habitats Marsilea quadrifolia L. produces different types of leaves above and below the water level. In aseptic cultures growth conditions can be manipulated so that leaves of the submerged type are produced continuously. Under such conditions the application of either blue light or an optimal concentration of abscisic acid (ABA) induced the development of aerial-type leaves. When fluridone, an inhibitor of ABA biosynthesis, was added to the culture medium it did not prevent blue light induction of aerial leaf development. During blue light treatment the endogenous ABA level in M. quadrifolia leaves remained unchanged. However, after the plants were transferred to an enriched medium, the ABA level gradually increased, corresponding to a transition in development from the submerged type of leaves to aerial leaves. These results indicate that the blue light signal is not mediated by ABA. Therefore, in the regulation of heterophyllous determination, discrete pathways exist in response to environmental signals.

Five Hundred Twenty-two Resectoscopic Myomectomies

Between January 1985 and March 1996, 522 women with submucous myomas underwent resectoscopic myomectomy. Fifty-two were treated with subsequent endometrial ablation. To ensure easy and complete resection of sessile or large submucous myomata, the two-resectoscope method was used. To increase safety, the procedure was monitored by simultaneous ultrasound, and in 1995 Lin's myoma forceps was produced to facilitate the procedure. The average specimen weight was 23.9 g (505 patients). The largest intrauterine myoma was 148 g and the largest myoma delivery was 210 g. The average operating time was 34.2 minutes (517 patients). No uterine perforation occurred. No laparotomy was necessary during or after the operation. Almost all of the women experienced improvement of their symptoms.

Clinical applications of Lin's forceps in flexible hysteroscopy

Eighty-one patients underwent directed biopsy with a large Lin's biopsy forceps during flexible hysteroscopy performed without cervical dilatation or anesthesia. Ninety-seven specimens were obtained, with an average size of 74.5 3(. For control study, 18 women underwent directed biopsy with a small conventional biopsy forceps. Nineteen specimens were obtained, with average size 3.4 mm3( (p <0.05). In eight women, lost intrauterine devices were retrieved with a large Lin's grasping forceps, which can easily grasp the device directly and remove it during flexible hysteroscopy.

Isolation of a cDNA encoding a 70 kDa heat-shock cognate protein expressed in vegetative tissues of Arabidopsis thaliana

A cDNA encoding a 70 kDa heat shock 'cognate' protein (hsc70) was isolated from Arabidopsis thaliana by using a rat hsc70 cDNA as probe. Sequence analysis demonstrated the conservation of functional domains and important amino acid residues among hsc70s in plants and animals. The expression of this gene was stress-inducible, and was found at a substantial level during normal growth in root, stem, leaf and flower tissues, but not in siliques. Multiple copies of this gene exist in the Arabidopsis genome.

Removing a large submucous fibroid hysteroscopically with the two-resectoscope method

Hysteroscopic myomectomy was performed in 25 patients using resectoscopes of two different sizes because of large submucous fibroids causing severe menorrhagia and anemia. The cervix was softened and dilated by inserting a laminaria tent the night before the operation. During the procedure a 7-mm resectoscope was first used to cut the pedicle to a size smaller than 10 mm. A sessile myoma was resected into a pedunculated myoma, and its body resected with a 9-mm resectoscope. The smaller portions were removed with a pair of forceps. Simultaneous ultrasonography was used to monitor the procedure. Specimen weights ranged from 50 to 145 g (mean 78.5 g). The operation time was 13 to 118 minutes (mean 49 min). No complications were encountered, other than a cervical laceration caused by forceps. Postoperatively, 22 patients had improvement of menorrhagia and anemia. Three women underwent the same procedure due to recurrence of the fibroid; two had full-term deliveries. Our method has proved to be safe and efficient for treatment of a sessile or large submucous fibroid.

Outcome of removal of intrauterine devices with flexible hysteroscopy in early pregnancy

Removal of intrauterine devices (IUDs) in early pregnancy, when the IUDs threads are not visible at the cervical canal and the patient wishes to continue her pregnancy, remains a problem. Thirty-three patients using IUDs with nonvisible filaments on examination underwent flexible hysteroscopy for retrieval of the devices and follow-up until delivery. In all cases, hysteroscopies were performed without cervical dilatation and anesthesia. In 30 patients, the devices were found within the uterine cavity, and 28 IUDs were removed. In the remaining 3 patients, no IUD was observed. Twenty-four healthy children have been born. Six other patients requested a dilatation and curettage (D & C) about 1-2 weeks later after successful IUD removal. In 2 women, examinations were done at 22 and 29 weeks antepartum, and these 2 patients were lost to follow up. Operative fiberoptic hysteroscopy is proposed as a useful and effective method of retrieval of IUDs in early pregnancy when the filaments of the IUD are absent.

The disappearance of an hsc70 species in mung bean seed during germination: purification and characterization of the protein

We have purified a 73 kDa protein from the cytosolic fraction of mung bean seeds. It comprises 0.5-1% of the total protein in seeds. This purified protein is a bona fide hsc70 on the basis of several lines of evidence. First, antibodies against bovine brain hsc70 cross-react with the purified 73 kDa protein. Second, the purified protein comigrates on two-dimensional gels with one of the heat-inducible hsc70s in mung bean seedlings. Third, similar to other hsc70 species, the purified 73 kDa protein has a high affinity for ATP. Finally, the hydrolysis of ATP by the purified protein can be stimulated by peptides; ATPase activity increases from 40 nmol/h to 165 nmol/h per mg of protein. The purified mung bean hsc70 autophosphorylates at a substoichiometric level. Moreover, the amount of this hsc70 species diminishes while new species of hsc70s appear after germination, suggesting that the expression of hsc70 in mung bean is subject to developmental regulation.

Clinical applications of a new Fujinon operating fiberoptic hysteroscope

A soft and rigid operating fiberoptic hysteroscope (4.8 mm outer diameter) was developed by Lin et al., with the support of a Fuji Photo Optical Company. The functional part of the telescope consists of three sections: a soft, flexible front section, a rigid rotating middle section, and a semirigid, self-retaining rear section. With these features, the intrauterine target can be approached easily, directly, and closely, usually without cervical dilation or anesthesia and with the operator in a comfortable position. Clinical applications were divided into four groups: (1) directed biopsy, (2) transcervical tubocornual recanalization for the management of cornual occlusion, (3) hysteroscopic chorionic villus sampling, and (4) the removal of lost IUDs. Experience with 153 procedures is presented. No complications were encountered. The authors conclude that this new hysteroscope is a very useful tool for the treatment of intrauterine lesions, used easily in the office and the operating room alike.

Nucleic acid and protein synthesis during lateral root initiation in Marsilea quadrifolia (Marsileaceae)

The pattern of DNA, RNA, and protein synthesis during lateral root initiation in Marsilea quadrifolia L. was monitored by autoradiography of incorporated of 3H-thymidine, 3H-uridine, and 3H-leucine, respectively. DNA synthesis was associated with the enlargement of the lateral root initial prior to its division. Consistent with histological studies, derivatives of the lateral root initial as well as the cells of the adjacent inner cortex and pericycle of the parent root also continued to synthesize DNA. RNA and protein synthetic activities were found to be higher in the lateral root initials than in the endodermal initials of the same longitudinal layer. The data suggest a role for nucleic acid and protein synthesis during cytodifferentiation of a potential endodermal cell into a lateral root initial.

The Fujinon diagnostic fiber optic hysteroscope. Experience with 1,503 patients

A soft and rigid diagnostic fiber optic hysteroscope (outer diameter, 3.7 mm) was developed. A total of 1,503 women underwent panoramic, televised fiber optic hysteroscopy without cervical dilation. No anesthesia, analgesia or tenaculum was required. No complication was encountered during or after the operation. The procedure is simple, easy and safe, with the operator in a relaxed and comfortable position even when the patient has acute flexion of the uterus. Our clinical results prove that the soft and rigid structure of the fiberscope offers advantages over rigid scopes or conventional fiberscopes with full-length soft, malleable parts.

[Pharmacokinetic and clinical studies on cefodizime in the field of obstetrics and gynecology]

Pharmacokinetic and clinical studies on cefodizime (THR-221, CDZM) were carried out and the following results were obtained. Concentrations of CDZM in serum and uterine tissues were determined from 38 to 282 minutes after drip infusion of 1 g CDZM. CDZM reached peak level of 25.0 micrograms/g or higher in each tissue during a period of 38 to 83 minutes. Concentrations of CDZM in the dead space exudate after drip infusion of 2 g CDZM were also studied. At 240 minutes after injection, CDZM concentration in exudate reached a peak of 46.88 micrograms/ml. These levels far exceeded MICs of CDZM against major pathogens most often isolated in the field of obstetrics and gynecology. CDZM was administered to 7 patients with their diseases diagnosed as pelvic peritonitis (4 cases) or acute adnexitis (3 cases) at a dose of 2-4 g per day for 6-14. days. Clinical response was good in all cases. Transient elevation of liver function was noticed in 2 cases. No other adverse reactions were noted during the study.

Root contraction in hyacinth. II. Changes in tubulin levels, microtubule number and orientation associated with differential cell expansion

Root contraction in hyacinth (Hyacinthus orientalis L.) is marked by reoriented cell growth in the cortex of the contractile region. Cellular volume of the inner cortex enlarges fourfold during root contraction. This is associated with large increases in the radial and tangential dimensions and decreases in the longitudinal dimension of the cells. In order to determine the possible role of microtubules (MTs) in these changes we compared tubulin levels and MT numbers and orientation in contracted and non-contracted regions of hyacinth roots. Tubulin content was analysed by a radioimmunoassay; MT numbers and orientation were analyzed by counting profiles in sectioned material using transmission electron microscopy. Contracted tissue was found to have significantly higher levels of tubulin on a per-cell basis than non-contracted tissue, and also increased tubulin levels relative to total protein. The spatial MT frequencies were the same in contracted and non-contracted tissues, indicating a proportional increase in MT numbers in the expanded cells. Although the absolute spatial frequency of MTs was constant, the orientation, as determined by morphometric analysis of MT profiles, was not. While in the longitudinal section plane 42% of the MTs in the non-contracted cells were oblique, in the contracted cells the percentage of MTs presenting oblique profiles increased to 87%. Additionally, a qualitative difference in MTs was observed in contracted cells; electron-opaque material was seen peripherally associated with the MTs of the inner cortex. The changes in tubulin levels and in MT numbers as well as the qualitative differences in the MTs of contracted and non-contracted root regions indicate that, in hyacinth, reoriented cellular enlargement associated with root contraction cannot be explained simply by shifts in the arrangement of preexisting cortical MT arrays, but involves more complex changes in the cytoskeleton.

[The development of a new operating hysteroscopic fiberscope and its clinical application]

A new operating hysteroscopic fiberscope consisting of soft and rigid parts (4.8mm outer diameter) was developed with the support of Fuji Photo Optical Company. The working part of the scope can be divided into three sections: A flexible soft front section, a rotary rigid middle section and a flexible self retained semirigid rear section. With these functional parts the intrauterine target can be approached directly to perform the following operations. 1. Directed intrauterine biopsy. Thirty-five patients diagnosed as having endometrial polyp (13), submucous myoma (8), endometrial hyperplasia (4), endocervical polyp (3), endometrial carcinoma (2) and others (5) underwent direct biopsy with hysteroscopic control. No cervical dilatation or anesthesia was necessary. 2. Transcervical recanalization. In six cases of proximal tubal occlusion, a ureteral catheter or a percutaneous coronary balloon angiocatheter was introduced into the tubal ostium of the obstructed side to resolve the occlusion successfully with concomitant laparoscopy. 3. Hysteroscopic chorionic villus sampling. Chorionic villus sampling was performed with a ureteral catheter under direct hysteroscopic control and ultrasound guidance in eighteen pregnant women at from seven to fourteen gestational weeks. In fifteen cases, the samplings were performed satisfactory. 4. Removal of a lost IUD. Three cases of lost IUD underwent hysteroscopic removal without difficulty. Our results have proved that this scope is a very useful tool for intrauterine operations.

[The development of a new flexible hysterofiberscope and its clinical application]

Hysteroscopy is a diagnostic method for intrauterine lesion. Most kinds of hysteroscope are rigid in type. Cervical dilatation and insertion of the trocar are necessary for hysteroscopy. These procedures can be very painful to the patient. Also subsequent blood clotting and injury to the endometrium may interfere with the diagnosis. With the help of Fuji Photo Optical Company, a new flexible hysterofiberscope (3.7 mm in diameter) was developed. The scope is divided into three portions; a front flexible part, a rigid middle part and a soft rear part. Cervical dilatation and anesthesia were not required even in a primiparous woman. The operator can observe the cervical canal, the uterine cavity and the tubal ostium very easily in a comfortable position. From Nov. 85 to Sep. 86 we carried out hysteroscopy in 411 patients with this new scope. The fluid medium which we used was a solution of 10% dextrose in water. The indications for hysteroscopy were abnormal uterine bleeding (187 cases), uterine myoma (80 cases), sterility (52 cases), post-transcervical surgery (22 cases) and others (70 cases). No complications were encountered during or after the procedure. The results were satisfactory. This new flexible hysterofiberscope has been proved an efficient tool for intrauterine diagnosis.

Three-contrasts method: an ultrasound technique for monitoring transcervical operations

The "three-contrasts method" of ultrasonography is designed to monitor transcervical operations for submucous uterine myomas and uterine septa when a pediatric urologic resectoscope is used. This monitoring method has proved more effective than concomitant laparoscopy. The pediatric resectoscope can also be used efficiently for diagnostic and therapeutic purposes without dilating the cervical canal.

Transcervical resection of submucous myoma

Thirteen women with chief complaints of menorrhagia and metrorrhagia underwent transcervical resection (TCR) of pedunculated submucous myoma using either an operating hysteroscope or urologic resectoscope. Eight women received TCR with a urologic resectoscope without further operation. Subsequent vaginal hysterectomy was performed on one woman after TCR of a large prolapsed submucous fibroid with a urologic resectoscope because of adenomyosis. Three women underwent TCR of the same type of large prolapsed submucous myoma with an operating hysteroscope. Later, due to other pathologic lesions of the uterus, subsequent vaginal hysterectomies were done on two women and a subsequent abdominal hysterectomy on another woman. Without TCR of these large prolapsed submucous myoma, subsequent vaginal hysterectomies were not possible. Only one woman underwent TCR of submucous myoma with an operating hysteroscope without further operation. All patients showed improvement in such clinical symptoms as menorrhagia, metrorrhagia, and anemia. Before TCR, we make it a rule to use a new diagnostic hysteroscope (4mm external sheath) to reevaluate the position and size of the fibroid. The fluid media used were 10% dextrose for diagnostic hysteroscopy, 5% dextrose for therapeutic hysteroscopy and 10% urigal for urologic resectoscopy. Three months after the operation, second look hysteroscopy is arranged. All patients except one have been followed up at our outpatient department.

[Study on the correlation between self-priming effect of LH-RH and luteal insufficiency by LH-RH two step test]

To clarify not only the releasing function but the self-priming effect of gonadotropins in the anterior pituitary gland, two step administration of 100 micro-grams of synthetic LH-RH at a 60 minute interval (LH-RH two step test) was investigated in 19 women with luteal insufficiency, 7 women in puerperium (3rd-10th postpartum) and 6 women immediately after first ovulation following spontaneous abortion (pregnancy 5-7 weeks). In the luteal phase, blood samples were drawn at 0', 30', 60', 90', 120' and 180' after first LH-RH stimulation for measurement of serum LH and FSH by radioimmunoassays. delta 1 standing for hormone release = 1st peak level -0' level. delta 2 standing for selriming effect = 2nd peak level -60' level. delta 1 delta 2 ratio = delta 2/delta 1. In the luteal insufficiency group, delta 1 was significantly higher and delta 1 delta 2 ratio was lower than those in the control group. In the puerperium group, delta 1 and delta 2 responses were not detected, suggesting marked depression of the pituitary function by pregnancy. In the aborted group delta 1 and delta 2 were similar to those in the control group, indicating rapid recovery of the pituitary function. This study demonstrated that the LH-RH two step test was useful in evaluating luteal function by measuring gonadotropins.

[Fundamental and clinical studies on imipenem/cilastatin sodium in the field of obstetrics and gynecology]

Fundamental and clinical studies on imipenem/cilastatin sodium (MK-0787/MK-0791) were carried out and the following results were obtained. Concentrations of MK-0787 in plasma and uterine tissues were determined at 30 minutes to 390 minutes after the completion of an intravenous drip infusion of 500 mg/500 mg of MK-0787/MK-0791 sodium. Levels of MK-0787 in oviduct, ovary, endometrium, myometrium, uterine cervix and portio vaginalis were 5.1, 5.3, 4.2, 6.6, 5.2 micrograms/g and 6.0 micrograms/g, respectively, at 30 minutes after the completion of the infusion. These levels far exceeded the MICs of MK-0787 against major pathogens (Gram-negative rods and anaerobic bacilli) most often isolated in the field of obstetrics and gynecology. MK-0787/MK-0791 was administered by intravenous drip infusion to 11 patients, including 4 with pelvic peritonitis, 4 with adnexitis and one each with peritonitis, tubo-ovarian abscess, and endometritis, at a dose of 1 g/1 g-1.5 g/1.5 g per day for a period of 4 to 9 days. Clinical response was excellent in 2 and good in 9. No adverse reactions or abnormal laboratory findings were observed in any of the patients.

Characterization of T cell subsets using monoclonal antibodies in nasopharyngeal carcinoma patients

Peripheral blood T cell subsets from 99 patients with nasopharyngeal carcinoma (NPC), 38 age-matched healthy subjects, and 20 patients with head and neck cancer other than NPC were characterized by reactivity with monoclonal antibodies. Patients with NPC showed much lower values of percentage and absolute number of common T cells (OKT3+) and helper cells (OKT4+) (p less than 0.01) than the control groups. The percentage of suppressor cells (OKT8+) was found to be higher in NPC patients than in healthy persons (p less than 0.001), but the absolute number was still lower in NPC patients. A selective decrease in the ratios of OKT4+ to OKT8+ cells was found in NPC patients (p less than 0.001). The ratios were correlated inversely to the clinical stage (r = 0.294, p less than 0.01). After negative selection by complement-mediated cytolysis, the remaining cells were stimulated with phytohemagglutinin. Net counts of isotope incorporation were smaller in all T cell subsets of NPC patients (p less than 0.001). These data indicate that the depressed cell-mediated immunity in NPC patients is due to inadequate number and functions of T cell subsets and a relative increased proportion of suppressor T cells.

Response of lymphocyte subpopulations to phytohemagglutinin, concanavalin A and pokeweed mitogen in patients with nasopharyngeal carcinoma

The mitogenesis of lymphocyte subpopulations in response to phytohemagglutinin (PHA), concanavalin A (Con A) and pokeweed mitogen (PWM) were studied in 75 patients with nasopharyngeal carcinoma (NPC) and in 51 healthy controls. The net increments of isotope incorporation of either T cells or B cells in NPC patients with PHA, Con A or PWM stimulation were far less than those in controls, with statistical significance (p less than 0.001) respectively. However, there was no link between the mitogenesis and the clinical stage. It is concluded that it is of doubtful value to use quantitative mitogenesis in NPC patients as a prognostic indicator. A study of loco-regional immune response is suggested.

[Diagnostic significance of LH-RH two step test in women with normoestrogenic amenorrhea: analysis of the self-priming effect of the anterior pituitary glands]

To investigate the self-priming effect of gonadotropin on the anterior pituitary glands, the response of serum gonadotropins to the "LH-RH two step test" (two step administration of 100 micrograms of synthetic LH-RH at a 60 minute interval) was studied in 20 women with normoestrogenic amenorrhea who were responsive to the progesterone test. The patients were divided into two groups according to the results of the clomiphene test. Blood samples were collected before LH-RH stimulation and 30, 60, 90, 120, 180 minutes after the first stimulation, respectively. The P1P2 ratio (2nd peak level/1st peak level) and delta 1 delta 2 ratio (delta 2/delta 1 = 2nd peak level-60 min. level/1st peak level-0 min. level) of LH and FSH in the clomiphene-positive group were significantly higher than those in the clomiphene-negative group. These ratios are regarded as the degree of the self-priming effect, and at least partially reflect the capacity for the synthesis of pituitary gonadotropins. The results demonstrate that the self-priming effect is more restored in the clomiphene-positive group than in the clomiphene-negative group, and the data also indicate that the analysis of the self-priming effect with the "LH-RH two step test" is useful in developing new diagnostic criteria on ovarian dysfunction.

[Response of subunits of human pituitary gonadotropins to LH-RH 2 step stimulations in ovarian dysfunction]

To investigate the alteration of pituitary gonadotropin subunits in ovarian dysfunction by two step administration of LH-RH at 60 minutes interval, specific and sensitive radioimmunoassays of the subunits were utilized for this study. Blood samples were obtained from thirteen women of ovarian dysfunction and from fifteen normal women of subunits. The definition of delta 1 and delta 2 was as follows. delta 1(hormone release) = 30 (or 60) min value-0 min value. delta 2(hormone synthesis and release) = 90 (or 120, 180)-60 min value. delta 1 delta 2 ratio = delta 2/delta 1. Correlation was observed between the value of native gonadotropic hormones and the value of their subunits (LH-alpha and LH-beta) in normal women but no correlation was detected in delta 1 and delta 2 values in ovarian dysfunction. Thus LH-RH 2 step test suggest the possibility to differentiated pituitary function in both normal and abnormal subjects. The analysis of gonadotropin subunits was useful to develop new diagnostic criteria of ovarian dysfunction.

[Study on the functions of synthesis and release of gonadotropins of the pituitary gland in human subjects by LH-RH 2-step test]

The pituitary gonadotropin response of synthesis and release to two step stimulation by 100 micrograms of LH-RH at 60 minutes interval was studied by radioimmunoassay of LH and FSH in normal menstrual cycling and menopause women and adult males. The blood samples were collected before LH-RH stimulation and 30, 60, 90, 120 minute after the first stimulation, respectively. The value of delta 1 was defined as either higher value at 30 or 60 minute minus the value at 0 minute. The value of delta 2 was defined as either higher value at 90, 120, or 180 minute minus the value of 60 minute. delta 1 Was explained as the release of pituitary gonadotropin and delta 2 standed for the release and synthesis of pituitary gonadotropin. delta 1 delta 2 Ratio was expressed as delta 2/delta 1 100%. If delta 2 was higher than delta 1, subsequently the value of delta 1 delta 2 ratio was larger than 100. When delta 1 was more than delta 2, then the value of delta 1 delta 2 ratio was smaller than 100. In normal menstrual women delta 1 of LH were as Preovulatory phase greater than Follicular phase greater than or equal to Luteal phase, delta 2 were as Preovulatory phase greater than Luteal phase greater than Follicular phase. The value of both delta 1 and delta 2 of FSH were Preovulatory phase greater than Follicular phase greater than Luteal phase. The delta 1 of serum LH of menopause women and adult males were higher whereas delta 2 of both serum LH and FSH of adult males were extremely low in value. delta 1 And delta 2 of serum FSH in menopause women showed higher values than those of others. delta 1 delta 2 Ratio of LH and FSH of both follicular phase and luteal phase were more than 100, indicating dominant pattern of synthesis of gonadotropin. The delta 1 delta 2 ratio of LH at preovulatory phase and of both LH and FSH in menopause women and adult males were smaller than 100, suggesting dominant pattern of release of pituitary gonadotropin. These dates suggest that our LH-RH two step test was more useful to clarify anterior pituitary function in terms of both synthesis and release of gonadotropin.