[Incidence and case fatality rates of cardiovascular diseases in urban and rural community-dwelling populations in eastern, central and western regions of China]

Objective: To evaluate the incidence and case fatality rate of cardiovascular disease (CVD) among populations in urban and rural communities in eastern, central and western regions of China. Methods: The present study was based on the data of the Prospective Urban and Rural Epidemiology (PURE)-China cohort, which enrolled participants who had at least one follow-up visit and complete information on age and sex. Information on baseline demographics, cardiovascular risk factors, and prevention and treatment for CVD were collected. CVD and mortality events were documented using the standardized case report form of the PURE Global Study to assess the incidence and case fatality rate of CVD among populations in urban and rural communities in eastern, central and western China. Results: This study included a total of 47 262 community-dwelling participants (age: (51.1±9.6) years; female, n=27 529, 58.2%) from 115 urban and rural communities in 12 provinces across the eastern, central, and western regions of China. Over a follow-up period of 11.9 (9.5, 12.6) years, 2 686 deaths and 5 873 cardiovascular events were documented. The incidence of CVD was 11.90 (95%CI: 11.60-12.21)/1 000 person-years. A significant difference in CVD incidence was observed across regions (Ptrend<0.001), which was highest in the western provinces (13.99 (95%CI: 13.33-14.65)/1 000 person-years), intermediate in the eastern provinces (11.92 (95%CI: 11.52-12.33)/1 000 person-years), and lowest in the central provinces (8.87 (95%CI: 8.25-9.50)/1 000 person-years). The 1-year case fatality rate of CVD demonstrated an increasing trend from eastern to western regions (eastern: 10.20% (95%CI: 6.95-14.73); central: 13.50% (95%CI: 9.90-18.14); western: 18.62% (95%CI: 14.95-22.94); Ptrend<0.001). Moreover, the incidence of major CVD was consistently higher in rural areas compared with urban areas across eastern (P<0.001), central (P=0.01) and western (P<0.001)_regions, respectively. The 1-year case fatality rate in rural areas was also significantly higher compared with that in urban areas in both eastern (P<0.001) and western regions (P=0.02). Conclusions: The incidence and case fatality rate of CVD were high among middle-aged population in China, especially those in western regions with low socioeconomic levels and in rural areas.

Gut bacterial metabolites modulate endoplasmic reticulum stress

Background

The endoplasmic reticulum (ER) is a membranous organelle that maintains proteostasis and cellular homeostasis, controlling the fine balance between health and disease. Dysregulation of the ER stress response has been implicated in intestinal inflammation associated with inflammatory bowel disease (IBD), a chronic condition characterized by changes to the mucosa and alteration of the gut microbiota. While the microbiota and microbially derived metabolites have also been implicated in ER stress, examples of this connection remain limited to a few observations from pathogenic bacteria. Furthermore, the mechanisms underlying the effects of bacterial metabolites on ER stress signaling have not been well established.

Results

Utilizing an XBP1s-GFP knock-in reporter colorectal epithelial cell line, we screened 399 microbiome-related metabolites for ER stress pathway modulation. We find both ER stress response inducers (acylated dipeptide aldehydes and bisindole methane derivatives) and suppressors (soraphen A) and characterize their activities on ER stress gene transcription and translation. We further demonstrate that these molecules modulate the ER stress pathway through protease inhibition or lipid metabolism interference.

Conclusions

Our study identified novel links between classes of gut microbe-derived metabolites and the ER stress response, suggesting the potential for these metabolites to contribute to gut ER homeostasis and providing insight into the molecular mechanisms by which gut microbes impact intestinal epithelial cell homeostasis.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13059-021-02496-8.

QRICH1 dictates the outcome of ER stress through transcriptional control of proteostasis

Tissue homeostasis is perturbed in a diversity of inflammatory pathologies. These changes can elicit endoplasmic reticulum (ER) stress, protein misfolding, and cell death. ER stress triggers the unfolded protein response (UPR), which can promote recovery of ER proteostasis and cell survival or trigger programmed cell death. Here, we leveraged single-cell RNA sequencing to define dynamic transcriptional states associated with the adaptive versus terminal UPR in the mouse intestinal epithelium. We integrated these transcriptional programs with genome-scale CRISPR screening to dissect the UPR pathway functionally. We identified QRICH1 as a key effector of the PERK-eIF2α axis of the UPR. QRICH1 controlled a transcriptional program associated with translation and secretory networks that were specifically up-regulated in inflammatory pathologies. Thus, QRICH1 dictates cell fate in response to pathological ER stress.

Bias-minimized quantification of microRNA reveals widespread alternative processing and 3' end modification

MicroRNAs (miRNAs) modulate diverse biological and pathological processes via post-transcriptional gene silencing. High-throughput small RNA sequencing (sRNA-seq) has been widely adopted to investigate the functions and regulatory mechanisms of miRNAs. However, accurate quantification of miRNAs has been limited owing to the severe ligation bias in conventional sRNA-seq methods. Here, we quantify miRNAs and their variants (known as isomiRs) by an improved sRNA-seq protocol, termed AQ-seq (accurate quantification by sequencing), that utilizes adapters with terminal degenerate sequences and a high concentration of polyethylene glycol (PEG), which minimize the ligation bias during library preparation. Measurement using AQ-seq allows us to correct the previously misannotated 5' end usage and strand preference in public databases. Importantly, the analysis of 5' terminal heterogeneity reveals widespread alternative processing events which have been underestimated. We also identify highly uridylated miRNAs originating from the 3p strands, indicating regulations mediated by terminal uridylyl transferases at the pre-miRNA stage. Taken together, our study reveals the complexity of the miRNA isoform landscape, allowing us to refine miRNA annotation and to advance our understanding of miRNA regulation. Furthermore, AQ-seq can be adopted to improve other ligation-based sequencing methods including crosslinking-immunoprecipitation-sequencing (CLIP-seq) and ribosome profiling (Ribo-seq).

Zonula occludens-1 associated nucleic acid binding protein plays an invasion-promoting role in bladder cancer

Cancer cell invasion is an important characteristic of malignant tumors. Cancer cells overcome the constraints of tight junctions (TJ) to invade other tissues, but less is known about the regulating role of tight junction on bladder cancer (BC) invasion. In order to identify the invasion-regulating function of tight junction component, we investigated the oncogenetic features of zonula occludens-1 associated nucleic acid binding protein (ZONAB), a TJ protein that is usually highly expressed in solid cancers. Expression of ZONAB was found to be up-regulated in human BC cell lines detected by real-time PCR, Western blotting. ZONAB expression was significantly up-regulated in BC cell lines and negatively regulated E-cadherin expression. Overexpression of ZONAB by stable transduction in human BC cell lines promoted invasion detected by transwell invasion assay. Conversely, stable suppression of ZONAB expression by RNA interference (RNAi) in BC cells attenuated invasion. A similar role for ZONAB in promoting invasion and EMT was observed in xenografts. In summary, ZONAB is up-regulated in BC cell lines, which promotes invasion, demonstrating the important role it plays in tumorogenesis and cancer progression.

Randomized clinical trial of elective resection versus observation in diverticulitis with extraluminal air or abscess initially managed conservatively

Background

The aim of this RCT was to determine whether elective resection following successful non-operative management of a first episode of acute sigmoid diverticulitis complicated by extraluminal air with or without abscess is superior to observation in terms of recurrence rates.

Methods

This was a single-centre, sequential design RCT. Patients were randomized to elective surgery or observation following non-operative management and colonoscopy. Non-operative management included nil by mouth, intravenous fluids, intravenous antibiotics, CT with intravenous contrast on arrival at hospital, and repeat CT with intravenous and rectal contrast on day 3 in hospital. The primary endpoint was recurrent diverticulitis at 24 months. Patients with a history of sigmoid diverticulitis, immunosuppression or peritonitis were not included.

Results

Of 137 screened patients, 107 were assigned randomly to elective surgery (26) or observation (81), and underwent the allocated intervention after successful non-operative management. Conservative management failed in 15 patients. Groups were similar in age, sex, BMI, co-morbidities and colorectal POSSUM. Rates of recurrent diverticulitis differed significantly in the elective surgery and observation groups (8 versus 32 per cent; P = 0·019) at a mean(s.d.) follow-up of 37·8(8·6) and 35·2(9·2) months respectively. There was also a significant difference in time to recurrence (median 11 versus 7 months; P = 0·015). A total of 28 patients presented with recurrent diverticulitis complicated by extraluminal air and/or abscess (2 elective surgery, 26 observation), all of whom recovered with repeat non-operative management.

Conclusion

The majority of patients observed following conservative management of diverticulitis with local extraluminal air do not require elective surgery. Registration number: NCT01986686 (http://www.clinicaltrials.gov).

Does laparoscopic intracorporeal ileocolic anastomosis decreases surgical site infection rate? A propensity score-matched cohort study

AIM

Foreshortened mesentery or thick abdominal wall constitutes a rationale for laparoscopic intracorporeal ileocolic anastomoses (ICA). The aim of this study was to compare intracorporeal to extracorporeal ICA in terms of surgical site infections in patients with Crohn's ileitis and overweight patients with right colon tumors.

METHOD

This was a prospective propensity score-matched cohort study enrolling consecutive patients with Crohn's terminal ileitis and overweight patients with right colon tumors undergoing elective laparoscopic right colon resection with intracorporeal or extracorporeal ICA. Propensity score matching with a 1:1 ratio was employed to compare diagnosis-matched patients for age, BMI, ASA, and previous abdominal surgery.

RESULTS

Overall, 453 patients were enrolled: 233 intracorporeal vs. 220 extracorporeal. Propensity score matching left 195 intracorporeal and 195 extracorporeal patients comparable for age (p = 0.294), gender (p = 0.683), ASA (p = 0.545), BMI (p = 0.079), previous abdominal surgery (p = 0.348), and diagnosis (p = 0.301). Conversion rates (5.1 vs. 3.6%; p = 0.457) and intraoperative complications (1 vs. 2.1%; p = 0.45) were similar. Overall morbidity (5.1 vs. 12.8%; p = 0.008) and re-intervention rates (3.1 vs. 8.7%; p = 0.029) were significantly higher in extracorporeal patients. Anastomotic leak rates (0.5 vs. 1.5%; p = 0.623) did not differ. Incisional SSI rate was significantly higher in extracorporeal patients (p = 0.01).

CONCLUSION

Laparoscopic intracorporeal ICA reduced incisional SSI rates as compared to its extracorporeal counterpart.

HPV16 E6 mutations and p53 codon72 polymorphism among women with cervical intraepithelial neoplasia 2 and 3 in China

OBJECTIVE

To study the distribution of HPV16 E6 gene mutations and p53 codon72 polymorphism among women with HPV16+ cervical precancerous lesions and explore their relationship with the risk of cervical intraepithelial neoplasia (CIN) 2, 3. Materials and Meth- ods: This study analyzed a total of 112 cases of exfoliated HPV16+ cervical cell specimens which were divided into group I (normal and CIN1, 55 cases) and group2 (CIN2, 3, 57 cases). Among the 112 specimens, 85 cases were successfully amplified for HPV E6 gene by PCR and the PCR products were sequenced directly. P53 codon72 region was also amplified from the 112 specimens and the PCR products were sequenced directly and compared with the standard sequence.

RESULTS

Among the 85 amplified HPV sequences, point mutations such as T178G, T350G, G132A, A442C, T310G, G94T, C551A, etc. were found, among which, T178G showed the highest rate (51.76%). The rate of HPV16 E6 mutation T178G in CIN2, 3 group was significantly higher than that in normal and CINI group, i.e., in the 112 amplified p53 codon72 sequences, the distribution of Pro/Pro genotype in normal, and CIN1 group was significantly different from that in CIN2, 3 groups, and the disease risk of Pro/Pro genotype was much higher than that of Arg/Arg and Arg/Pro genotypes.

CONCLUSION

HPV16 E6 T178G mutation increases the disease risk of CIN2, 3. Meanwhile, compared with Arg/Arg and Arg/Pro genotypes, p53 codon72 Pro/Pro genotype more associated with the disease risk of CIN2, 3.

Simulated training in colonoscopic stenting of colonic strictures: validation of a cadaver model

AIM

There are currently no available simulation models for training in colonoscopic stent deployment. The aim of this study was to validate a cadaver model for simulation training in colonoscopy with stent deployment for colonic strictures.

METHOD

This was a prospective study enrolling surgeons at a single institution. Participants performed colonoscopic stenting on a cadaver model. Their performance was assessed by two independent observers. Measurements were performed for quantitative analysis (time to identify stenosis, time for deployment, accuracy) and a weighted score was devised for assessment. The Mann-Whitney U-test and Student's t-test were used for nonparametric and parametric data, respectively. Cohen's kappa coefficient was used for reliability.

RESULTS

Twenty participants performed a colonoscopy with deployment of a self-expandable metallic stent in two cadavers (groups A and B) with 20 strictures overall. The median time was 206 s. The model was able to differentiate between experts and novices (P = 0. 013). The results showed a good consensus estimate of reliability, with kappa = 0.571 (P < 0.0001).

CONCLUSION

The cadaver model described in this study has content, construct and concurrent validity for simulation training in colonoscopic deployment of self-expandable stents for colonic strictures. Further studies are needed to evaluate the predictive validity of this model in terms of skill transfer to clinical practice.

Analysis of one year follow-up of women with cervical cytology report of atypical squamous cells and the diagnostic role of high-risk HPV infection

OBJECTIVE

To investigate the risk of developing cervical intraepithelial neoplasia grade 2 (CIN2) or greater disease in patients with cytology report of atypical squamous cells of undetermined significance (ASC-US) or cannot exclude high-grade atypical squamous cells (ASC-H) in one year follow-up.

STUDY DESIGN

Analysis of colposcopy-directed multiple cervical biopsies in all patients. Patients without CIN2 or greater diseases were tested for human papillomavirus (HPV) DNA at the enrollment and at 12th month and followed up by cytology at the 6th and 12th month. Patients with repeated abnormal results were subjected to colposcopy-directed biopsy.

RESULTS

A total of 894 ASC-US and 101 ASC-H patients were enrolled. The rate of CIN2 or greater disease was 14.2% in ASC-US group and 46.5% in ASC-H group, at the first test respectively. A total of 65.0% of patients in ASC-US have completed the study and 47.5% repeatedly showed abnormal cytology, while the same rates in ASC-H were 62.7% and 50%. Only four cases were diagnosed with CIN2 in ASC-US group. The rate of HPV DNA becoming negative was 54.9% and 51.5% for ASC-US and ASC-H, respectively.

CONCLUSIONS

The diagnosis rate of CIN2 or greater lesions in ASC-US and ASC-H patients was about 15% and 46.5%, respectively, within one year.

Correlation of cervical intraepithelial neoplasia with expressions of p16 and Ki67 in exfoliated cervical cells in fluid-based thin-layer samples

OBJECTIVE

To understand the correlation of cervical intraepithelial neoplasia (CIN) with the expressions of p16 and Ki67 in exfoliated cervical cells obtained by fluid-based thin-layer technology.

STUDY DESIGN

The distributions ofpl6 and Ki67 positive cells in 116 patients with cytologically diagnosed atypical squamous cells of undetermined significance (ASC-US) or human papilloma virus (HPV) positive were examined by immunocytochemistry. Data were analyzed by the rank sum test, crosstab test, and receiver operating characteristic (ROC) curves.

RESULTS

When the thresholds for p16 and Ki67 positive were set as 6.5 and 4.5 positive cells per 100 exfoliated cervical cells, respectively, the expressions of Ki67 and P16 are significantly higher in the exfoliated cervical cells of patients with CIN II or greater compared with those in patients with CIN I or less.

CONCLUSION

Immunocytochemical examination of p16 and Ki67 expressions in the exfoliated cervical cells of fluid-based thin-layer samples could be used for the detection of CIN II or greater.

Bacterial vaginosis is conducive to the persistence of HPV infection

We investigated the effects of bacterial vaginosis (BV) on the outcomes of high-risk human papillomavirus infection (HR-HPV). BV was diagnosed on Papanicolaou-stained cytology slides of 707 HPV-positive patients. HR-HPV DNA expression was analysed using the Hybrid Capture II (HC-II) assay. Of the 707 HR-HPV-positive female patients, 298 (42.1%) exhibited clearance of HR-HPV. The remaining 409 patients had persistent HR-HPV infection. The persistent HR-HPV group and the clearing group had similar rates of BV at the beginning of the study. At the end of the study, the persistent HR-HPV group had a BV prevalence of 11.2% while the clearing group had a significant lower BV prevalence of 5.0%. A decreased clearance of HPV was found in women with current BV, compared with women without BV. Furthermore, the natural history of HPV was not affected by the HPV viral load or the BV prevalence at the beginning of the study (P > 0.05). Bacterial vaginosis appears conducive to the persistence of HPV infection.

Twelve-month follow-up detection of high-risk human papillomavirus (HPV) DNA for 93 cases with cervical intraepithelial neoplasia grade 2 or 3 (CIN 2-3) after a loop electrosurgical excisional procedure (LEEP)

PURPOSE

The purpose of this study was to follow-up cervical intraepithelial neoplasia grades 2 or 3 (CIN2/3) cases after a loop electrosurgical excisional procedure (LEEP) by liquid-based cytology (LBC) and detection of HPV DNA.

METHODS

LEEP was performed for the first diagnosed CIN2/3 cases. Six and 12 months after LEEP, LBC and HPV DNA detection were performed.

RESULTS

The number of cases with CIN2 accounted for 64.5% (60/93) of the total cases before LEEP. Six months post LEEP, the number of cases with normal LBC and negative HPV DNA accounted for 63.4% (59/93). Cases with abnormal LBC accounted for 17.2 (16/93), and cases with persistent positive HPV DNA accounted for 11.8% (7/93). Two cases had both persistent positive HPV DNA and abnormal LBC. A vaginal intraepithelial neoplasm (VAIN2) was found in one of the HPV DNA persistent positive cases. Twelve months post LEEP, 4.3% (8/93) of the cases were HPV DNA positive. Abnormal LBC was observed in four cases (of which 2 cases were HPV DNA positive) with normal LBC and negative HPV DNA at six months post LEEP.

CONCLUSION

HPV DNA examination is instrumental for the detection of VAIN.

[Management of anastomotic stenosis after lower extremity bypass surgery with cutting balloon angioplasty]

PURPOSE

Conventional balloon angioplasty of anastomotic stenosis following bypass surgery is insufficient at mid- and long-term. However, short-term results with cutting balloon angioplasty (CBA) are satisfactory. The purpose of this study is to determine the long-term results using this technique. Materials and methods. Between January 2002 and January 2006, all patients with anastomotic stenosis more than one month after bypass surgery, shorter than 2 cm and>50%, were referred without randomisation to CBA.

RESULTS

A total of 19 patients with mean age of 63.5 years (55-82 years), 14 males and 5 females, were included. Twenty stenoses (femoral n=15, popliteal n=4 and calf n=1) managed with CBA affected 17 infrainguinal and 2 suprainguinal bypasses. One patient had anastomotic stenoses at both extremities. The rate of technical success aws 100%. Mean follow-up was 32 months (12-42). Three deaths occurred during follow-up. One patient presented with restenosis at 3 months, successfully treated with repeat CBA. No thrombosis or infection was observed.

CONCLUSION

The results with CBA appear persistent and compete favorably with results from surgical repair. A randomized trial would be necessary to confirm these results.

[Diagnosis of breast-duct disease by breast duct endoscope]

OBJECTIVES

To study the pathological characteristics of breast-duct disease under breast duct endoscope in diagnosis and treatment of breast diseases.

METHODS

The images of breast duct of 62 patients with nipple discharge were obtained by hard breast duct endoscope (Olympus Inc) and computer assistant analysis system.

RESULTS

Of the 62 patients, malignant tumor was found in 4, premalignancy in 6, intradutal papilloma in 15, and mammary duct or plasma cell mastitis in 37.

CONCLUSIONS

Intraductal lesions of patients with nipple discharge can be observed and be followed up with breast duct endoscope. The accuracy of etiological diagnosis of patients with nipple discharge, after the use of breast duct endoscope can partly modify the indications for operation in patients with nipple discharge.

[Postprandial triglyceridemia and carotid atherosclerosis in male patients with coronary heart disease]

OBJECTIVE

To test the effect of postprandial accumulation of triglyceride-rich lipoprotein (TGRL) on carotid artery atherosclerosis.

METHODS

In 42 male cases with coronary heart disease (CHD) as verified by angiography, high density lipoprotein cholesterol and apolipoprotein B (ApoB) levels in fasting serum, serum triglyceride concentrations before and 2, 4, 6, 8 hours after a standard fat test meal were measured. Each patient underwent a carotid artery high-resolution B-mode ultrasound examination. The extent of alimentary lipemia [area under the triglyceride curve over 8 hours, TG-AUC and peak triglyceride response (TGPR)] correlated with the carotid artery intima-media thickness.

RESULTS

Univariate analyses indicated both TG-AUC and TGPR had direct correlation with mean intima-media thickness measured from four well-defined vessel wall segments in the left and right carotid arteries (r = 0.45 and 0.41, both P < 0.01). After controlling for age, body mass index (BMI), triglyceride, HDL-C, and apolipoprotein B concentrations in fasting serum with multivariate stepwise regression analysis, the above correlation remained. There was an independent inverse correlation between HDL-C and carotid artery intima-media thickness.

CONCLUSION

It is suggested that abnormal metabolism and clearance of postprandial TGRL can promote the progression of atherosclerosis.

Extrahepatic biliary cystadenocarcinoma arising from the left hepatic duct

A 54-year-old man, who had no clinical symptoms, underwent a routine health checkup at our hospital. Abdominal ultrasonography disclosed a well demarcated tumor containing a solid portion occupying the dilated left hepatic duct and a cystic portion expanding into the parenchyma of the left hepatic lobe, with mild dilatation of the intrahepatic bile ducts. These findings were later confirmed by computed tomography (CT) and magnetic resonance imaging. Endoscopic retrograde cholangiography revealed a complete defect at the level of the left hepatic duct, while drip infusion cholangiographic-CT (DIC-CT) disclosed a defect of the left hepatic duct only, with the distal portions of the left intrahepatic ducts being visualized on the image. Hepatic angiography revealed light stains in the solid portion in the parenchymal phase. At left lobectomy, a multiloculated polyp-like tumor was found arising from the left hepatic duct and expanding into the parenchyma of the left hepatic lobe. Microscopically, all the lining cells in the cysts and the tumor cells in the solid portion showed the features of papillary adenocarcinoma. In this patient with extrahepatic biliary cystadenocarcinoma, DIC-CT was useful in identifying the site of origin of the tumor, and hepatic angiography was also useful in differentiating this rare malignant tumor from benign cystadenoma.

Targeting HIV-1 to Fc gamma R on human phagocytes via bispecific antibodies reduces infectivity of HIV-1 to T cells

In addition to CD4, the primary receptor to which the human immunodeficiency virus type 1 (HIV-1) binds, mononuclear phagocytes (monocytes) express three classes of Fc receptors for immunoglobulin G (Fc gamma R). We have previously shown that infection of monocytes by HIV-1 is inhibited when bispecific antibodies (BsAbs) are used to target the virus to either the type I, type II, or type III Fc gamma R on these cells. Infection of monocytes was not inhibited when HIV-1 was targeted to either human leukocyte antigen class I or CD33. We have extended these studies to examine the ability of BsAbs plus polymorphonuclear leukocytes (neutrophils, PMNs) and monocytes to reduce infectivity of HIV-1 to cells from the human T cell lymphoma line, H9. The production of HIV-1 following interaction of virus with BsAb and phagocytes was determined in an indicator cell assay by mixing BsAb, HIV-1, and phagocytes with uninfected H9 cells. Productive infection of H9 cells was quantitated on subsequent days by measuring p24 gag antigen levels in supernatants by enzyme-linked immunosorbent assay. Our findings show that the addition of interferon-gamma-activated PMNs or monocytes to cultures of HIV-1 plus H9 cells in the absence of BsAb results in a marked reduction in p24 levels equivalent to 85 to 90% of control levels. With the combination of BsAb (anti-Fc gamma RI x anti-gp120) plus IFN-gamma-activated phagocytes, levels of p24 in H9 cultures were below those at culture initiation. These findings demonstrate that IFN-gamma-activated phagocytes can affect the natural course of HIV-1 infection of T cells, a finding of potential clinical importance.

[Focal infectious lesions of the renal parenchyma. Comparative contribution of echography and x-ray computed tomography]

Nineteen cases of focal infectious lesions of renal parenchyma studied included 10 cases of acute focal bacterial nephritis (AFBN) and 9 of abscess, cases of pyelonephritis without radiological signs being excluded from this report. Each patient had been investigated by intravenous urography (IVU), ultrasound and CT scan imaging. Comparison of value of the different radiological explorations showed that urographic signs were inconstant and only weakly specific, the most valuable examination being CT scan imaging. The latter images show hypodense zones, clearer with contrast, of a rather triangular form and either single or multiple in AFBN, and mainly nodular images in abscess cases. Ultrasound is of intermediate value, being of high performance in cases of abscess but failing to demonstrate AFBN in about half the cases. However, it should not be totally neglected because of its case of access.

[Carcinosarcoma of the gallbladder. Echographic and anatomopathological diagnosis. Apropos of a case with review of the literature]

Precise diagnosis of carcinosarcoma of gallbladder, a rare tumor, is based on histopathology since clinical and epidemiologic elements fail to differentiate it from other gallbladder cancers. Ultrasound imaging is the most effective radiodiagnostic technique since it allows visualization of the tumor and suggests the presence of a carcinosarcoma when a polypoid or vegetating mass is detected within the gallbladder.

Quantification of salicylate in serum by use of salicylate hydroxylase

In this enzymatic method for salicylate in serum, Pseudomonas salicylate hydroxylase (EC 1.14.13.1) is used. This stable enzyme catalyzes the stoichiometric, unidirectional conversion of salicylate and NAD(P)H to catechol and NAD(P)+ in the presence of molecular oxygen. The concentration of salicylate in a clinical sample is determined by measuring the delta A at 340 nm as compared with a standard. This new method is rapid, highly specific, requires 40 microL or less of sample, and we saw no interference by any of 61 commonly used drugs. Lipemic, icteric, or hemolyzed samples can be used. Furthermore, this method does not involve extraction, deproteinization, or derivatization. Results are precise and agree well with those obtained by the Trinder test.

Quantification of salicylate in serum by use of salicylate hydroxylase

In this enzymatic method for salicylate in serum, Pseudomonas salicylate hydroxylase (EC 1.14.13.1) is used. This stable enzyme catalyzes the stoichiometric, unidirectional conversion of salicylate and NAD(P)H to catechol and NAD(P)+ in the presence of molecular oxygen. The concentration of salicylate in a clinical sample is determined by measuring the delta A at 340 nm as compared with a standard. This new method is rapid, highly specific, requires 40 microL or less of sample, and we saw no interference by any of 61 commonly used drugs. Lipemic, icteric, or hemolyzed samples can be used. Furthermore, this method does not involve extraction, deproteinization, or derivatization. Results are precise and agree well with those obtained by the Trinder test.

Salicylate and mitochondrial injury in Reye's syndrome

Electron microscopic and spectrophotometric studies showed that salicylate causes gross swelling of mitochondria in isotonic salt solutions. In overall morphology the salicylate-treated mitochondria resembled those from patients with Reye's syndrome. Salicylate analogs such as m-hydroxybenzoate, p-hydroxybenzoate, and benzoate did not exert this effect. The mitochondria deformed by salicylate tended to return to their original condensed form on removal of the drug.

Determination of the hydride transfer stereospecificity of nicotinamide adenine dinucleotide linked oxidoreductases by proton magnetic resonance

A facile proton magnetic resonance technique is described for the determination of the coenzyme stereospecificity during hydride transfer reactions catalyzed by pyridine nucleotide dependent oxidoreductases. The reliability of this technique was demonstrated by examining the coenzyme stereospecificity of lactate, malate, and 3-phosphoglycerate dehydrogenases, which are known to be A-stereospecific enzymes, as well as triosephosphate and octopine dehydrogenases, which are known to be B-stereospecific enzymes. Furthermore, by applying this technique, it was shown that the previously unstudied enzymes D-beta-hydroxybutyrate and 4-aminobutanal dehydrogenases are B- and A-stereospecific enzymes, respectively. In addition, the nicotinamide adenine dinucleotide linked reaction of glucose-6-phosphate dehydrogenase from Leuconostoc mesenteroides was found to be B stereospecific, like the reaction of the nicotinamide adenine dinucleotide phosphate linked yeast enzyme.