Added value of spectral computed tomography quantitative parameters for differentiating tuberculosis-associated fibrosing mediastinitis from endobronchial lung cancer: initial results

OBJECTIVE

The objective of this study was to explore the added value of spectral computed tomography (CT) parameters to conventional CT features for differentiating tuberculosis-associated fibrosing mediastinitis (TB-associated FM) from endobronchial lung cancer (EBLC).

METHODS

Chest spectral CT enhancement images from 109 patients with atelectasis were analyzed retrospectively. These patients were divided into two distinct categories: the TB-associated FM group (n = 77) and the EBLC group (n = 32), based on bronchoscopy and/or pathological findings. The selection of spectrum parameters was optimized with the least absolute shrinkage and selection operator regression analysis. The relationship between the spectrum parameters and conventional parameters was explored using Pearson's correlation. Multivariate logistic regression analysis was used to build spectrum model. The spectrum parameters in the spectrum model were replaced with their corresponding conventional parameters to build the conventional model. Diagnostic performances were evaluated using receiver operating characteristic curve analyses.

RESULTS

There was a moderate correlation between the parameters ㏒(L-AEFNIC) - ㏒(L-AEFC) (r= 0.419; p< 0.0001), ㏒(O-AEF40KeV) - ㏒(O-AEFC) (r= 0.475; p< 0.0001), [L-A-hydroxyapatite {HAP}(I)] - (L-U-CT) (r= 0.604; p< 0.0001), {arterial enhancement fraction (AEF) derived from normalized iodine concentration (NIC) of lymph node (L-AEFNIC), AEF derived from CT40KeV of bronchial obstruction (O-AEF40KeV), arterial-phase Hydroxyapatite (Iodine) concentration of lymph node [L-A-HAP(I)], AEF derived from conventional CT (AEFC), unenhanced CT value (U-CT)}. Spectrum model could improve diagnostic performances compared to conventional model (area under curve: 0.965 vs 0.916, p= 0.038).

CONCLUSION

There was a moderate correlation between spectrum parameters and conventional parameters. Integrating conventional CT features with spectrum parameters could further improve the ability in differentiating TB-associated FM from EBLC.

Preoperative CT histogram analysis to predict the expression of Ki-67 in solid pseudopapillary tumours of the pancreas

AIM

To explore the value of preoperative computed tomography (CT) histogram features in predicting the expression status of Ki-67 in patients with solid pseudopapillary pancreatic tumours (SPTP).

MATERIALS AND METHODS

This retrospective study analysed venous phase CT images of 39 patients with SPTP confirmed at surgery and histopathology and measured using the Ki-67 proliferation index from November 2015 to February 2022. According to the Ki-67 proliferation index, they were divided into high expression (Ki-67 ≥ 4%) and low expression (Ki-67 < 4%) groups. The histogram features of quantitative parameters were extracted using MaZda software, and the quantitative parameters of CT histograms were compared between groups. The receiver operating characteristic (ROC) curves of the patients were plotted according to the parameters, with statistically significant differences. The area under the curve (AUC), sensitivity, and specificity were calculated, and the effectiveness of the histogram parameters in predicting Ki-67 expression was analysed and evaluated.

RESULTS

In total, 27 SPTP patients were enrolled, including 11 with high expression of Ki-67 and 16 with low expression. Comparative analysis of the Ki-67 high- and low-expression groups revealed a statistically significant in necrosis and variance (p<0.05). ROC curve analysis showed that the AUC of necrosis and variance predicting Ki-67 expression status were 0.753 and 0.841, the sensitivities were 81.8% and 81.3%, and the specificities were 68.7% and 81.8%, respectively.

CONCLUSION

Preoperative CT histogram features help predict Ki-67 expression status in patients with SPTP.

Role of traveling microplastics as bacterial carriers based on spatial and temporal dynamics of bacterial communities

Microplastics (MPs) are considered as distinct substrates for bacterial colonization, they can carry bacterial communities to travel around environments. The bacterial communities on traveling MPs prefer to be gradually consistent with those on local MPs that were always in the same environment, and this process of change in the bacterial communities on traveling MPs was called 'localization'. However, the dynamics of localization process and their influencing factors are still unclear. Therefore, we simulated the MPs migration process along the water flow direction in the estuary. We used quantitative analysis to study the dynamics of bacterial communities on the migrated MPs. We found the localization characteristics depended on the differences between the former and latter environments, as well as the preexisting bacteria. The localization degree was higher when the former and latter environments were similar. In most cases, compared with the first cultivation of pristine MPs, the time for localization was shorter. Moreover, although the entire bacterial communities tended to be localized, the preexisting bacteria on the migrated MPs had selective effects on subsequent bacterial colonization. Furthermore, the preexisting bacteria on MPs could set up the connections with the bacteria that existed at the latter site, and the stability of the entire bacterial communities on the migrated MPs increased with time. Overall, our findings indicated that the localization characteristics of bacterial communities on traveling MPs were related to the precultured time and environmental differences, which were helpful to understand the colonized bacteria transportation and MPs ecological effects.

Correlation of pericoronary adipose tissue CT attenuation values of plaques and periplaques with plaque characteristics

AIM

To investigate the relationship between different plaque characteristics and pericoronary adipose tissue (PCAT) computed tomography (CT) attenuation values for plaques and periplaques.

MATERIALS AND METHODS

The data from 188 eligible patients with stable coronary heart disease (280 lesions) who underwent coronary CT angiography between March 2021 and November 2021 were collected retrospectively. All PCAT CT attenuation values of plaques and periplaques (the area within 5 and 10 mm proximal and distal to the plaque) were calculated, and multiple linear regression was used to assess their correlation with different plaque characteristics.

RESULTS

PCAT CT attenuation of plaques and periplaques was higher in non-calcified plaques (-73.38 ± 10.41 HU, -76.77 ± 10.86 HU, 79.33 ± 11.13 HU, -75.67 ± 11.24 HU, -78.63 ± 12.09 HU) and mixed plaques (-76.83 ± 8.11 HU, -79 [-85, -68.5] HU, -78.55 ± 11 HU, -78.76 ± 9.9 HU, -78.79 ± 11.06 HU) than in calcified plaques (-86.96 ± 10 HU, -84 [-92, -76] HU, -84.14 ± 11.08 HU, -84.91 ± 11.41 HU, -84.59 ± 11.69 HU; all p<0.05) and higher in distal segment plaques than in proximal segment plaques (all p<0.05). Plaque PCAT CT attenuation was lower in plaques with minimal stenosis than in plaques with mild or moderate stenosis (p<0.05). The significant determinants of PCAT CT attenuation values of plaques and periplaques were non-calcified plaques, mixed plaques, and plaques located in the distal segment (all p<0.05).

CONCLUSIONS

PCAT CT attenuation values in both plaques and periplaques were related to plaque type and location.

INOCA affects more than the coronaries

Background

Ischaemia with normal coronary arteries (INOCA) may result in disabling symptoms and has an association with adverse long-term prognosis. The diagnosis of INOCA necessitates invasive coronary angiography to perform a physiological evaluation of microvascular function.

The conjunctiva has a readily assessable microvascular network in which physiological parameters can be evaluated. We compared conjunctival haemodynamics in patients with and without coronary microvascular disease (MVD) to assess if systemic microvascular dysfunction was present in this coronary artery disease sub-group.

Methods

In this study, we recruited patients undergoing invasive coronary angiography for the investigation of angina or angina equivalent symptoms. All patients had physiologically insignificant epicardial disease (FFR≥0.80) and underwent a physiological evaluation of coronary microvascular function. We compared a group with evidence of coronary MVD (IMR≥25 or CFR&lt;2.0); to a group of controls without MVD (IMR&lt;25 and CFR≥2.0).

The conjunctival microvasculature was imaged using a previously validated combination of a smartphone and slit-lamp biomicroscope. The conjunctival vasculature was assessed using a semi-automated process of vessel diameter measurement and erythrocyte tracking to obtain haemodynamic parameters of microvascular function.

Results

A total of 111 patients were included (43 MVD and 68 controls). There were no differences in baseline demographics, co-morbidities, epicardial coronary disease severity or regular pharmacological therapies between the groups. Mean coronary flow reserve (CFR) was lower and mean index of microcirculatory resistance (IMR) higher in the MVD cohort (CFR 2.5±1.3 vs 5.2±2.5, p&lt;0.001 and IMR 28.4±11.8 vs 13.7±5.0, p&lt;0.001).

A total of 2295 conjunctival vessels were analysed. The mean number of vessels per patient was 21.0±12.8 (3.2±3.5 arterioles and 14.8±10.8 venules). Significant reductions in axial/cross-sectional velocity, wall shear rate and wall shear stress were observed in the MVD cohort. Table 1 demonstrates a comparison of conjunctival physiological parameters between the groups.

The most marked differences were observed in conjunctival arterioles. Due to the heterogenous size distribution of microvessels, arterioles were categorised into 2 diameter sub-groups (10–25 μm and 25–40 μm) for analysis (Table 2).

Conclusion

The reductions in microvascular blood flow velocity and rate that form the basis for the diagnosis of coronary microvascular dysfunction can be observed non-invasively in the bulbar conjunctiva microcirculation. Conjunctival vascular imaging may have utility as a non-invasive imaging modality to both diagnose microvascular dysfunction and augment conventional cardiovascular risk stratification.

Funding Acknowledgement

Type of funding sources: Foundation. Main funding source(s): Belfast Trust Heart Trust Fund and Northern Ireland Chest Heart and Stroke

Effects of phytase supplementation on production performance, egg and bone quality, plasma biochemistry and mineral excretion of layers fed varying levels of phosphorus

Excessive fecal excretion of phosphorus (P) has increasingly become an environmental issue due to oversupply of P in layer rations, and thus it is imperative to minimize safety margins for P to ensure the sustainability of the egg industry. In this study, a 12-week feeding trial (22 to 34 weeks of age) was conducted to evaluate the effects of phytase supplementation on production performance, plasma biochemistry, egg and bone quality and P excretion of laying hens fed various levels of non-phytate P (NPP). Forty-eight Lohmann white laying hens were randomly allocated to one of six corn-soybean meal-oat-based diets: diets containing 2.0, 2.5 or 3.0 g/kg NPP without phytase, and diets containing 1.0, 1.5 or 2.0 g/kg NPP with phytase (1 000 U/kg diet) where phytase inclusion was expected to provide 1.0 g/kg NPP to laying hens, thus making the phytase-unsupplemented treatment served as a control for the phytase-supplemented treatment accordingly. Productive performance was recorded during the experimental period. Blood and egg samples were collected, and digestibility studies were conducted at weeks 6 and 12 of the experiment. Bone mineralization was evaluated at the end of the experiment. Egg weight and egg production, feed consumption, BW and feed conversion ratio of laying hens fed lower NPP diets supplemented with phytase were comparable to those of hens fed high NPP phytase-unsupplemented controls. Eggshell thickness, specific gravity, Haugh units, tibia bone mineral density, tibia ash percent, plasma P and other biochemical parameters were not significantly different among dietary treatments. Total P intake, excretion and retention were affected by diet (P < 0.001), but its deposition in eggs was not significantly different. Contrast analysis further showed that total P excretion of phytase present vs phytase absent was averagely reduced by 40.4 mg/hen per day (P < 0.01). Moreover, total P excretion was linearly (P < 0.01) reduced with lowering dietary NPP, and this relationship was similar regardless of whether phytase was supplemented or not. The results from this study indicated that NPP levels in laying hen diets could be reduced to 1.0 g/kg (excluding the portion of NPP released by phytase) with the inclusion of phytase, without negative effects on production performance and health of the hens, thereby diminishing P excretion into environment.

Effect of dietary n-3 polyunsaturated fatty acids on the composition of cecal microbiome of Lohmann hens

Supplementation of n-3 fatty acids to poultry diets is widely acknowledged for its role in enhancing poultry products, however, little is known about the compositional responses of gut microbial communities to type and dosage of these supplements.  Here, we compared the effects of n-3 polyunsaturated fatty acids (PUFA), supplied as alpha-linolenic acid (ALA) or docosahexaenoic acid (DHA), on the composition of bacterial communities in ceca of laying hens.  Corn-soybean basal diets were supplemented with either flaxseed oil (FO, ALA-rich) or marine algal biomass (MA, DHA-rich), and each supplied 0.20 and 0.60% of total n-3 PUFA in the diet.  Lohmann LSL-Classic laying hens (n = 10/treatment) were randomly allocated to one of the 4 diets.  After 8 weeks of feeding, blood, liver and cecal digesta samples were obtained for plasma glucose, fatty acids, and short chain fatty acids analyses, respectively.  The gut bacterial communities were characterized using genomic DNA extracted from cecal contents, whereby the V3-V4 hypervariable region of the 16S rRNA gene was sequenced using the Illumina Miseq® platform.  Firmicutes and Bacteroidetes were the predominant phyla in both the FO- and MA-fed groups.  The relative abundance of Tenericutes, often associated with immunomodulation, was relatively higher (P<0.0001) in the FO than MA group.  Although the relative abundance of Bacteroides was greater for the FO- than the MA-fed group, this genus was negatively correlated (P<0.05) with total n-3 PUFA in the liver at higher dosages of both FO- and MA-fed hens.  Higher dose of FO (0.60%) and both dosages of MA (0.20 and 0.60%) substantially enriched several members of Firmicutes (e.g., Faecalibacterium, Clostridium and Ruminococcus) which are known to produce butyrate.  Moreover, co-occurrence network analysis revealed that, in the FO 0.60- and MA 0.20-fed hens, Ruminococcaceae was the most influential taxon accounting for about 31% of the network complexity.  These findings demonstrate that supplementation of different type and level of n-3 PUFA in hens' diets could enrich microbial communities with potential role in lipid metabolism and health.

Performance and tissue fatty acid profile of broiler chickens and laying hens fed hemp oil and HempOmegaTM

This study was conducted to determine the effects of hemp oil (HO) and HempOmega (HΩ), an equivalent product to HO, on performance and tissue fatty acid profile of layers and broiler chickens in two separate experiments. In the first experiment, forty 19-wk old Lohmann white laying hens were randomized to 1 of 5 dietary treatments, either a control diet or a control diet supplemented with 4 or 8% hemp oil provided by HO or HΩ, for a period of 6 wk (n = 8/diet). In experiment 2, 150-day-old mixed-sex (75 male; 75 female) Ross 308 chicks were randomly allocated into 5 dietary treatments, a control diet or a control diet supplemented with either 3 or 6% hemp oil provided by HO or HΩ, each with six replicates of 5 chicks for a 21-d feeding period. Performance of layers and broilers was not affected by dietary treatments. Animals provided with either HO or HΩ diets had greater total n-3 polyunsaturated fatty acids (PUFAs), alpha-linolenic acid (ALA), eicosapentaenoic acid (EPA), docosapentaenoic acid (DPA), and docosahexaenoic acid (DHA) in egg yolks, thighs, and breasts compared to the control diet (P < 0.01), and monounsaturated fatty acids (MUFAs) content of egg yolks and thighs decreased (P < 0.05). The levels of total n-6 PUFAs, linoleic acid (LA), or arachidonic acid (ARA) of the egg yolk and meat were generally not affected by dietary supplementation with HO or HΩ, but gamma-linolenic acid (GLA) was notably increased (P < 0.01). The current data show that inclusion of hemp oil up to 8% in layer diets and 6% in broiler diets provided by HO or HΩ does not negatively affect overall performance of birds and results in the enrichment of n-3 PUFAs and GLA in eggs and meat.

A meta-analysis evaluating the relationship between IL-18 gene promoter polymorphisms and an individual's susceptibility to HCV infection

BACKGROUND

Several observational studies have investigated interleukin-18 (IL-18) gene polymorphisms with regard to susceptibility to hepatitis C virus (HCV) infection, but the results have been inconsistent.

AIM

To evaluate the relationships between functional polymorphisms in the IL-18 gene and an individual's susceptibility to HCV infection, a meta-analysis was performed. Methods: A literature search was conducted using the PubMed, EMBASE, Web of Science and China BioMedicine databases to investigate the correlation between IL-18 gene polymorphisms and susceptibility to HCV infection. Crude odds ratios (ORs) with 95% confidence intervals (CIs) were calculated.

RESULTS

The polymorphisms IL-18-607 C>A and -137 G>C were correlated with susceptibility to HCV infection in Asian populations. However, there was no evidence indicating a correlation between either of these polymorphisms and susceptibility to HCV infection in Caucasian populations.

CONCLUSIONS

Our current meta-analysis suggests that the -607 C>A and -137 G>C polymorphisms in the IL-18 gene promoter play important roles in determining the response to HCV in Asian populations. More studies with larger sample sizes are needed to evaluate the associations between IL-18 genetic polymorphisms and HCV infection risk.

Dietary and ontogenic regulation of fatty acid desaturase and elongase expression in broiler chickens

Effects of diet and ontogeny on the expression of fatty acid desaturases and elongases were examined in broiler chickens. In Study 1, 120 day-old male chicks received one of six diets with LA:ALA ranging from 46:4 to 16:34, for 33 days. Total n-6 PUFA decreased, and n-3 PUFA increased in response to a decrease in the dietary LA:ALA. FADS1, FADS2, ELOVL2 and ELOVL5 mRNAs were highest (P<0.05) in birds fed lower LA:ALA diets. In Study 2, 60 day-old male chicks were fed a basal diet, and liver samples were collected on day of hatch, and on days 2, 7, 14, 21 and 35 post-hatch. Total n-6 and n-3 PUFA increased (P<0.01) from days 7 to days 21. FADS1, FADS2 and ELOVL2 mRNAs generally increased (P<0.01) with age. These findings provide evidence for the dietary and developmental regulation of PUFA metabolism in broiler chickens.

Chemotaxis and oospore formation in Phytophthora sojae are controlled by G-protein-coupled receptors with a phosphatidylinositol phosphate kinase domain

G-protein-coupled receptors (GPCRs) are key cellular components that mediate extracellular signals into intracellular responses. Genome mining revealed that Phytophthora spp. have over 60 GPCR genes among which a prominent class of 12 encoding novel proteins with an N-terminal GPCR domain fused to a C-terminal phosphatidylinositol phosphate kinase (PIPK) domain. This study focuses on two GPCR-PIPKs (GKs) in Phytophthora sojae. PsGK4 and PsGK5 are differentially expressed during the life cycle with the highest expression in cysts and during cyst germination, and at late infection stages. In P. sojae transformants that constitutively express RFP-tagged PsGK4 and PsGK5, the fusion proteins in hyphae reside in small, rapidly moving vesicular-like structures. Functional analysis using gene silencing showed that PsGK4-silenced transformants displayed higher levels of encystment and a reduced cyst germination rate when compared with the recipient strain. Moreover, GK4 deficiency (or reduction) resulted in severe defects in zoospore chemotaxis towards isoflavones and soybean roots. In contrast, PsGK5-silenced transformants exhibited no obvious defects in asexual development but oospore production was severely impaired. Both, PsGK4- and PsGK5-silenced transformants showed reduced pathogenicity. These results point to involvement of GKs in zoospore behaviour, chemotaxis and oospore development, and suggest that PsGK4 and PsGK5 each head independent signalling pathways.

Immunomodulation in young laying hens by dietary folic acid and acute immune responses after challenge with Escherichia coli lipopolysaccharide

We investigated the effects of dietary folic acid (FA) supplementation on immunological parameters in young laying hens under acute conditions of lipopolysaccharide (LPS) challenge. Twenty-four Shaver White laying hens at 24 wk were fed 2 diets in a completely randomized design. The diets were wheat-soybean based, with either 0 or 4 mg of supplemental FA per kilogram of diet. At 32 wk of age, 6 hens from each dietary treatment were injected intravenously with 8 mg/kg of BW of either LPS or saline. Four hours after injection, blood was collected and the hens were euthanized to obtain spleen and cecal tonsils. Heterophil:lymphocyte ratio, CD3+, CD4+, CD8+ T cells, and CD4+:CD8+ cells in the blood and spleen were not affected by dietary FA. Relative to saline-injected hens, LPS-injected hens had fewer (P < 0.05) CD3+, CD4+, CD8+, and CD4+:CD8+ cells in the blood, and no difference was found in the spleen. Total protein, albumin, and globulin were found to be higher (P < 0.05) in FA-supplemented hens compared with the control. However, total protein, albumin, and globulins decreased (P < 0.05) in the LPS-injected hens compared with the saline control. Expression of interleukin (IL)-1β in cecal tonsils decreased (P < 0.05) in FA-supplemented hens, but no dietary influence was found on the expression of other genes in both the spleen and cecal tonsils. Lipopolysaccharide upregulated (P < 0.05) expression of IL-10 and interferon (IFN)-γ in the spleen, and IL-1β, IL-10, and IFN-γ in the cecal tonsils, whereas the expression of Toll-like receptor (TLR)-4 and IL-8 was not influenced by LPS in the spleen and cecal tonsils. There was a diet × challenge interaction for total IgG, and cytokines IL-1β and IL-18 in the spleen as well as IL-18 in the cecal tonsils. In conclusion, there were few interactions of dietary FA and LPS; however, FA increased biochemical constituents, enhanced generation of total IgG, as well as exhibiting pleoitropic effects in inflammatory responses.

Effect of feeding hemp seed and hemp seed oil on laying hen performance and egg yolk fatty acid content: evidence of their safety and efficacy for laying hen diets

Forty-eight 19-wk-old Bovan White laying hens were fed 1 of 5 diets containing either hemp seed (HS) or hemp seed oil (HO). The level of HO was 4, 8, or 12%, whereas the level was 10 or 20% for the HS. A set of 8 birds fed wheat-, barley-, and corn oil-based diets served as the control. Performance was monitored over 12 wk. Average hen-day egg production was not affected upon feeding of either HS or HO diets. Egg weight was higher than that of the controls for hens consuming the 20% HS diet (P < 0.05). Feed intake was lower than that of the controls for birds consuming the 4% HO diet but similar across other treatments. Final BW were not affected by diet, with the exception of being lower than that of the controls (P < 0.05) in hens consuming the 12% HO diet. The total egg yolk n-3 fatty acid content increased linearly (P < 0.05) with increasing dietary α-linolenic acid provision with the HS- or HO-based diets. A quadratic response (P < 0.05) was observed for docosahexaenoic acid levels in egg yolk in response to increasing dietary α-linolenic acid supply. The expression of hepatic fatty acid desaturase 1 and 2, key genes for the desaturation of long-chain polyunsaturated fatty acids, was significantly decreased (50-60% of controls; P < 0.05) as a result of feeding HS or HO diets. Based on the results from the current study, the inclusion of the hemp products HS or HO in the diets of laying hens up to a maximum level of 20 and 12%, respectively, does not adversely effect the performance of laying hens and leads to the enrichment of the n-3 fatty acid content of eggs.

Chromosome homologies between tsessebe (Damaliscus lunatus) and Chinese muntjac (Muntiacus reevesi) facilitate tracing the evolutionary history of Damaliscus (Bovidae, Antilopinae, Alcelaphini)

Genome-wide homologies between the tsessebe (Damaliscus lunatus, 2n = 36) and Chinese muntjac (Muntiacus reevesi, 2n = 46) have been established by cross-species painting with Chinese muntjac chromosome paints. Twenty-two autosomal painting probes detected 35 orthologous segments in the tsessebe. Hybridization results confirmed that: (i) D. lunatus carries the (9;14) reciprocal translocation that has been proposed to be a derived chromosomal landmark shared by all species of the Antilopinae; (ii) the karyotype of D. lunatus can be derived almost exclusively from the bovid ancestral karyotype through 12 Robertsonian translocations involving 24 ancestral acrocentric autosomes; (iii) in addition to the Rb fusions, pericentric heterochromatic amplification has shaped the morphology of several of the D. lunatus chromosomes. Integrated analysis of these and published cytogenetic data on pecorans has allowed us to accurately discern the karyotype history of Damaliscus (D. lunatus; D. pygargus, 2n = 38; D. hunteri, 2n = 44). The phylogenomic relationships of 3 species reflected by specific chromosomal rearrangements were consistent with published phylogenies based on morphology, suggesting that chromosomal rearrangements have played an important role in speciation within the Alcelaphini, and that karyotype characters are valuable phylogenetic markers in this group.

Genome-wide comparative chromosome map between human and the Forrest's pika (Ochotona forresti) established by cross-species chromosome painting: further support for the Glires hypothesis

Comparative genomic data for ochotonids (pikas) are important for understanding the karyotype evolution of lagomorphs. Here, we have established the first genome-wide chromosomal homologies between human and the Forrest's pika (Ochotona forresti, 2n = 54) by cross-species chromosome painting. Integration of our map with the published comparative chromosome map between human and rabbit has enabled the establishment of an indirect homology map between Forrest's pika and domestic rabbit (Oryctolagus cuniculus, 2n = 44), representing the 2 Lagomorpha families: Leporidae and Ochotonidae. Our results demonstrate that (1) most of the proposed ancestral eutherian syntenies or syntenic associations have been retained in the O. forresti genome; (2) the HSA1/10p association, one of the 2 signature rearrangements that were proposed to support the grouping of the orders Lagomorpha and Rodentia into a monophyletic clade called Glires, is also present in the O. forresti genome; and (3) Robertsonian translocations have contributed to the karyotype differences between O. forresti and O. cuniculus.

Incorporating independent component analysis to Q-ball imaging for diffusion orientation distribution reconstruction

In this paper, we investigate the incorporation of independent component analysis (ICA) with Q-ball imaging (QBI) to extract information on the diffusion orientation distribution function (ODF) from an inner voxel. In our approach, the ICA algorithm is applied to a mixture of ODFs which are constructed based on the analytical QBI solution. The numerical simulation results demonstrate that the proposed ICA framework can not only successfully separate the diffusion ODF from the noisy diffusion data, but also achieves better performance compared with a QBI solution when the data has a low signal to noise ratio (SNR).

A study on the relationship between BOD(5) and COD in a coastal seawater environment with a rapid BOD measurement system

The dual objectives of this study are to: (1) examine the relationship between COD and BOD in seawater environment with a rapid but reliable method for the measurement of BOD in seawater, and (2) establish the relationship model between BOD(5) and COD in the firth of Dongbao River to predict the values of BOD(5). The first objective is met by the successful development of a technique utilizing bacteria-immobilized membrane flow cell for biodegradation process, coupled with fibre optic fluorescence detection for oxygen depletion quantitation. The technique has been applied to coastal seawater samples collected in the coastal area of Shenzhen, China. The BOD(5) and COD values for the samples are acquired and the results show that there is no apparent linear relationship existing between BOD(5) and COD in relatively clean seawater samples away from the shore. However, in estuary water samples containing relatively high concentration of sewage contamination, a linear correlation does exist between BOD(5) and COD. The linear relationship between the two parameters allows for the calculation of BOD(5) values based on COD data which can be measured more readily and precisely.

A study on the relationship between BOD5 and COD in coastal seawater environment with a rapid BOD measurement system

The dual objectives of this study are to: (1) examine the relationship between COD and BOD in seawater environment with a rapid but reliable method for the measurement of BOD in seawater, and (2) establish the relationship model between BOD(5) and COD in the firth of Dongbao River to predict the values of BOD(5). The first objective is met by the successful development of a technique utilizing bacteria-immobilized membrane flow cell for biodegradation process, coupled with fibre optic fluorescence detection for oxygen depletion quantitation. The technique has been applied to coastal seawater samples collected in the coastal area of Shenzhen, China. The BOD(5) and COD values for the samples are acquired and the results show that there is no apparent linear relationship existing between BOD(5) and COD in relatively clean seawater samples away from the shore. However, in estuary water samples containing relatively high concentration of sewage contamination, a linear correlation does exist between BOD(5) and COD. The linear relationship between the two parameters allows for the calculation of BOD(5) values based on COD data which can be measured more readily and precisely.

A theoretical study of the vibration and acoustics of ancient Chinese bells

In this paper, the acoustics of an ancient Chinese bell, which was made some 3000 years B.C., is studied theoretically. In ancient times, a set of the bells was used as a musical instrument. Unlike a western church bell and an ancient Indian bell, an ancient Chinese bell has two interesting acoustics. First, two tones can be heard separately as the bell is struck at two special points. The interval between the two pitches is always a minor or major third. Second, tones of the bell attenuate quickly, which is necessary for a musical instrument. So, an ancient Chinese bell is sometimes called a two-tone bell or a music bell. Although a three-dimensional model should be used to simulate the acoustics of the bell, a simplified model proposed in this paper does give some insight. Based on the lens-shaped cross section of an ancient Chinese bell, two tones of an ancient Chinese bell can be simulated by the vibration of a double-circular arch and the quick attenuation of tones can be simulated by acoustics of a cylinder with the lens-shaped cross section like a double-circular arch. Numerical results on the vibration and acoustics of the models are presented.

[Determination of lidocaine in human spinal cord by high-performance liquid chromatography]

A RPHPLC method for determining lidocaine in human's spinal cord. Was established. The linear range of the method was 0.20-20.0 micrograms/ml(r = 0.9999). The detection limit was 0.02 ng/ml(S/N > or = 3) and the clean-up recovery of lidocaine in human spinal cord was 82.4%-92.7%. The CV% were no more than 6.0% (N = 4). No interfere by other compounds was observed in study results using this method. RPHPLC method shows an excellent recovery, high sensitivity and good precision.

Endothelin plays a role in contractions of isolated pig pulmonary vessels induced by diaspirin cross-linked hemoglobin

The current studies were undertaken to investigate the role of endothelin-1 (ET-1) and its receptors in contractions of isolated pulmonary vessels of the pig induced by diaspirin cross-linked hemoglobin (DCLHb). Second-order pulmonary arteries (PAs) and veins (PVs) were isolated from pigs, cut into rings (4 to 5 mm), and mounted at optimal passive tension in 37 degrees C Krebs-filled tissue baths bubbled with 95% O2/5% CO2. Isometric tension was recorded continuously. In paired rings, concentration responses to ET-1 (10(-10) to 10(-7) mol/L), DCLHb (10(-9) to 3x10(-6) mol/L), and N-nitro-L-arginine (LNA) (10(-6) to 5x10(-5) mol/L) in the presence and absence of the ET(A) receptor antagonist BQ123 (3x10(-5) mol/L) were determined. PVs and PAs with intact endothelium and rings from which the endothelium was removed (denuded) were pretreated with the ET(B) receptor antagonist BQ788 to determine the contribution of ET(B) receptors to ET-1, DCLHb, and LNA responses. ET-1, DCLHb, and LNA caused concentration-dependent increases in tension in all vessels. In the presence of BQ123, the 50% effective concentration (EC50) of ET-1 was significantly increased (by 5-fold to 10-fold) in all vessels. DCLHb concentration responses were significantly attenuated-in the PVs by 45% and in the PAs by 79%-during treatment with BQ123. BQ123 attenuated LNA responses in PVs by 35% and in PAs by 87%. Treatment with BQ788 had no effect on endothelium-intact PVs or PAs but significantly increased ET-1 EC50 (log of the molar concentration) from -9.0+/-0.22 to -7.8+/-0.05 in denuded PAs. The ET-1 EC50 was significantly decreased in denuded PAs (-9.0+/-0.22) as compared with responses in endothelium-intact PAs (-8.1+/-0.18). DCLHb concentration responses were attenuated by 71% and LNA responses by 80% during antagonism with BQ788 in the intact PAs only. These data demonstrate that ET-1 plays a role in DCLHb-induced contractions in the PA and PV. The contributions of ET are mediated by both ET(A) and ET(B) receptors in the PA but only by ET(A) receptors in the PV. These results suggest that the vasoconstrictor actions of DCLHb, which have previously been shown to depend on its interference with endothelium-generated NO, may also involve ET. This may reflect the importance of the interaction of these two endothelium-generated physiologic antagonists in the pulmonary circulation.

Halothane attenuates nitric oxide relaxation of rat aortas by competition for the nitric oxide receptor site on soluble guanylyl cyclase

Endothelial cells play an important role in the regulation of vascular activity through the release of endothelium derived relaxing factor (EDRF) now believed to be nitric oxide (NO). NO and the NO donor drug nitroglycerin relax vascular smooth muscle by stimulating soluble guanylyl cyclase leading to elevation of intracellular levels of cyclic guanosine 3',5'-monophosphate (cGMP). Halothane has been shown to inhibit the action of NO on blood vessels. This study was designed to further investigate the mechanisms by which halothane attenuates NO-induced vascular relaxations. This was done by examining the effects of halothane on nitroglycerin and NO-induced relaxations in the presence and absence of the inhibitors of soluble guanylyl cyclase, methylene blue and 6-anilino-5,8-quinolinedione (LY 83583). Thoracic aortas from anesthetized male Sprague-Dawley rats were excised and cut into rings and the endothelium was removed. The aortic rings were suspended in organ baths containing Krebs solution and equilibrated at their optimal passive tension. When a stable plateau of contraction was produced by EC60 concentrations of norepinephrine, increasing concentrations of nitroglycerin or NO were added to the baths to relax the rings. This contraction-relaxation procedure was repeated three or four times. In some baths halothane was administered by a calibrated vaporizer 10 min before beginning the second procedure. Either methylene blue or LY 83583 was added to the baths 20 min before the third procedure. The combination of halothane, methylene blue or LY 83583 was added before the fourth procedure. Halothane, methylene blue or LY 83583 significantly inhibited nitroglycerin-induced relaxation individually. Halothane and LY 83583 also significantly inhibited NO-induced relaxations (5 x 10(-9)-3 x 10(-8) M and 5 x 10(-9)-3 x 10(-5) M, respectively) individually. The combination of halothane and methylene blue or halothane and LY 83583 significantly inhibited nitroglycerin-induced relaxation, also, the combination of halothane and LY 83583 significantly inhibited NO-induced relaxations. Halothane, methylene blue and LY 83583 treatment led to rightward shift in the concentration-effect curves. Halothane, in combination with methylene blue or LY 83583, produced inhibition equivalent to the sum of their individual effects. The present study demonstrates that the halothane, methylene blue and LY 83583 attenuate nitroglycerin and NO-induced relaxations of endothelium-denuded rat aortic rings. This suggests that halothane, methylene blue and LY 83583 may act through competitive antagonism at a common site of action on soluble guanylyl cyclase in the EDRF/NO relaxation pathway.

[The inhibitory effect of tissue plasminogen activator combined with 5-fluorouracil polyphase liposome on the scar formation in experimental filtration surgery]

OBJECTIVE

To study the effect of tissue plasminogen activator (t-PA) in combination with 5-fluorouracil (5-Fu) polyphase liposome on the prevention of scar formation in filtration surgery.

METHODS

Bilateral trabeculectomy filtering procedures were performed on 16 New Zealand white rabbits. The rabbits were divided into 4 groups of four rabbits each. In a randomized fashion, the first group received intracameral normal saline (0.1 ml) immediately following surgery and subconjunctival injection of 0.2 ml polyphase liposome (no drug) every 4 days serving as the control. The second group received intracameral t-PA 25 micrograms (0.1 ml) immediately following surgery. The third group received subconjunctival 5-Fu polyphase liposome 5 mg immediately after the procedures of filtration surgery and then every four days for another three injections. The fourth group received both intracameral t-PA 25 micrograms and subconjunctival 5-Fu polyphase liposome as in the third group. All eyes of the four groups were enucleated two weeks after the operation.

RESULTS

Two weeks after the surgery, the average intraocular pressure demonstrated a significant decrease in the third and fourth groups (P < 0.05), but did not show a significant decrease (P > 0.05) in the control and the second groups, as compared with the average preoperative intraocular pressure correspondingly. Morphometric analysis of the area of fibrosis from histopathological sections demonstrated a significant decrease of episcleral fibrosis in the three drug-treated groups as compared with the control group. Moreover, the area of fibrosis in the fourth group was the least among the three drug-treated groups. Analysis of variance of 2 x 2 factorial design showed that t-PA and 5-Fu polyphase liposome had synergetic effect on the inhibition in all of the drug-treated eyes.

CONCLUSION

Postoperatively, the inhibitory effect of intracameral t-PA combined with subconjunctival 5-Fu polyphase liposome on the scar formation in filtration surgery is more prominent than that of t-PA or 5-Fu used alone. They had synergetic effect on the inhibition of scar formation in filtration surgery.

Diaspirin cross-linked hemoglobin does not alter isolated human umbilical artery or vein tone

Diaspirin cross-linked hemoglobin (DCLHbTM; Baxter Healthcare Corp., Round Lake, IL, USA) is undergoing clinical trials as a blood substitute. Administration of DCLHb is associated with an increase of mean arterial pressure in vivo and contraction of selected adult isolated blood vessels of from certain species in vitro. The mechanisms of these pressor effects may be due to scavenging of the endothelium derived relaxing factor, nitric oxide (NO), by hemoglobin. Unlike adult blood vessels, prostacyclin (PGI2) rather than EDNO is the important relaxing agent in human umbilical vessels. In this study, we examined if DCLHb had vasoconstrictor effects on isolated human umbilical vessels. Human umbilical veins and arteries were excised, cut into rings and placed in organ chambers filled with 25 ml Krebs-Ringer solution (37 degrees C). 5-hydroxytryptamine (5-HT, 0.01-10 microM) increased the tension of human umbilical arteries (HUA, from 0.4 +/- 0.2 g to 2.6 +/- 0.4g) and veins (HUV, from 0.8 +/- 0.4g to 2.5 +/- 0.4g) in a dose-dependent manner. DCLHb (0.01-10 microM) did not have a significant effect on HUA and HUV. Substance P (1 microM, via prostanoid synthesis) and nitroglycerin (NG, 1 microM) but not acetylcholine (ACh, 1 microM) caused relaxation of both HUA and HUV. The NO synthase inhibitor L-NA did not have significant effects on HUA and HUV. DCLHb did not alter 5-HT preconstricted tension of HUA and HUV. The basal cGMP contents of HUA and HUV were low. These results support our previous finding that DCLHb-induced vasoconstriction in isolated vessels is dependent primarily on the binding of NO by hemoglobin.

Effects of halothane and isoflurane on carbon monoxide-induced relaxations in the rat aorta

BACKGROUND

Halothane and isoflurane previously were reported to attenuate endothelium-derived relaxing factor/nitric oxide-mediated vasodilation and cyclic guanosine monophosphate (cGMP) formation in isolated rat aortic rings. Carbon monoxide has many chemical and physiologic similarities to nitric oxide. This study was designed to investigate the effects of halothane and isoflurane on carbon monoxide-induced relaxations and cGMP formation in the isolated rat aorta.

METHODS

Isometric tension was recorded continuously from endothelium denuded rat aortic rings suspended in Krebs-filled organ baths. Rings precontracted with submaximal concentrations of norepinephrine were exposed to cumulative concentrations of carbon monoxide (26-176 microM). This procedure was repeated three times, with anesthetics delivered 10 min before the second procedure. Carbon monoxide responses of rings contracted with the same concentration of norepinephrine (10(-6) M and 2 x 10(-6) M) used in the anesthetic-exposed preparations also were examined. The concentrations of cGMP were determined in denuded rings using radioimmunoassay. The rings were treated with carbon monoxide (176 microM, 30 s) alone, or carbon monoxide after a 10-min incubation with halothane (0.34 mM or 0.72 mM). To determine whether the sequence of anesthetic delivery influenced results, vascular rings pretreated with halothane were compared with nonpretreated rings.

RESULTS

Carbon monoxide (26-176 microM) caused a dose-dependent reduction of norepinephrine-induced tension, with a maximal relaxation of 1.51 +/- 0.07 g (85 +/- 7% of norepinephrine-induced contraction). Halothane (0.34 mM and 0.72 mM) significantly attenuated the carbon monoxide-induced relaxations, but only the highest concentration of isoflurane (0.53 mM) significantly attenuated the carbon monoxide-induced relaxations. Carbon monoxide (176 microM) significantly increased cGMP content (+88.1 +/- 7.1%) and preincubation of the aortic rings with halothane (0.34 mM and 0.72 mM) inhibited this increase (-70.7 +/- 6.8% and -108.1 +/- 10.6%, respectively). When aortic rings and carbon monoxide were added simultaneously to Krebs solution equilibrated with halothane (0.72 mM), no inhibition of cGMP formation occurred.

CONCLUSION

Carbon monoxide-induced endothelium-independent relaxations of rat aortic rings were decreased by clinically relevant concentrations of halothane and isoflurane. The carbon monoxide-induced elevations of cGMP were attenuated by halothane only when the anesthetic was incubated with aortic rings before carbon monoxide treatment. The possible clinical significance of the actions of the anesthetics on this endogenous vasodilator is yet to be determined.

[Subconjunctival 5-fluorouracil polyphase liposome interference with scar formation in experimental filtration surgery]

OBJECTIVE

A comparative study was made to determine the effect of 5-fluorouracil (5-Fu) polyphase liposome and 5-Fu solution on the prevention of scar formation in filtration surgery.

METHOD

20 New Zealand white rabbits that underwent a standard trabeculectomy in both eyes were divided into two groups and each group consisted of 10 rabbits. Postoperatively, according to randomized fashion, in the first group, one eye received daily subconjunctival injection of 5 mg (0.2 ml) 5-Fu solution and the fellow eye received equal subconjunctival amount of normal saline serving as the control, in the second group, one eye received once subconjunctival injection of 5 mg (0.2 ml) of 5-Fu ployphase liposome with every 3 days apart and the fellow eye received the equal amount of subconjunctival injection of polyphase liposome serving as the control.

RESULTS

Two weeks after the surgery, the eyes treated with 5-Fu solution in the first group and 5-Fu polyphase liposome in the second group showed marked reduction of intraocular pressure (IOP, P < 0.05) and the control eyes of both groups did not reveal any marked reduction of IOP as compared with preoperative IOP respectively. Morphometric analysis of the areas of fibrosis in histologic section demonstrated a significant decrease (P < 0.002) in episcleral fibrosis in the eyes treated with 5-Fu solution and 5-Fu polyphase liposome as compared with their control eyes respectively. Superficial punctate keratopathy occurred in two of the 5-Fu solution-treated eyes (20%) and no toxic reaction was noted in the 5-Fu polyphase liposome-treated eyes.

CONCLUSION

Postoperatively, subconjunctival 5-Fu polyphase liposome instead of 5-Fu solution inhibits the scar formation at filtering site, and the therapy is safe and effective, leading to a higher success rate.

Contractile effects of diaspirin cross-linked hemoglobin (DCLHb) on isolated porcine blood vessels

The effects of diaspirin cross-linked hemoglobin (DCLHb) on vascular tone were examined in arterial and venous rings isolated from mesenteric, renal, femoral, and pulmonary blood vessels. Rings were placed in organ baths at optimal passive tension in Krebs' solution (37 degrees C) and aerated with a mixture of 95% O2/5% CO2. Vessels were treated with increasing concentrations of DCLHb or an iso-osmotic serum albumin solution. All artery and vein rings contracted in the presence of DCLHb. With the exception of the pulmonary vein, the magnitude of the tension increase with DCLHb was greater in the arteries than in the veins. Removal of the endothelium by scraping or the addition of a nitric oxide synthase inhibitor blocked the DCLHb-induced contraction in the pulmonary artery and vein. DCLHb also significantly reduced basal cyclic guanosine-3-5'-monophosphate in the pulmonary vein. These studies suggest that the constrictor activity of DCLHb is due primarily to inhibition of basal nitric oxide-induced relaxation of the vascular smooth muscle.

Effects of halogenated and non-halogenated anesthetics on diaspirin cross-linked hemoglobin induced contractions of porcine pulmonary veins

Diaspirin crosslinked hemoglobin (DCLHb) is a resuscitative fluid presently undergoing clinical trials. Administration of DCLHb is associated with an elevation of mean arterial pressure in vivo and contraction of isolated blood vessels in vitro. The mechanisms for the vascular actions are unknown but may be due to inhibition of nitric oxide (NO). Halothane has been reported to inhibit NO induced relaxation. We examined the effect of anesthetics on DCLHb induced contraction of blood vessels. Porcine pulmonary veins were excised, cut into rings and placed in organ chambers filled with 25 ml Krebs-Ringer solution (37 degrees C). Following equilibration at their optimal length the rings were exposed to increasing concentrations of serotonin(10(-8)M-10(-5)M). Endothelial activity was confirmed by relaxation greater than 80% with ACh (10(-6)M). DCLHb (1.5 x 10(-8)M to 6 x 10(-7)M) contracted porcine pulmonary veins (1.04 +/- 0.17g to 3.45 +/- 0.22g), and halothane (0.5% and 1%) significantly inhibited these DCLHb induced contractions in a dose-related manner (-41.6 +/- 8.1% and -73.3 +/- 8.2%, respectively). At equi-molar concentrations, isoflurane had no inhibitory activity. The relative effect of these volatile anesthetics is consistent with their inhibitory actions on other heme containing proteins. Propofol (10(-5)M) only has inhibitory effects on lower concentrations of DCLHb. Fentanyl did not have inhibitory effects. These results suggest that halogenated anesthetics may interact with the heme iron of DCLHb and inhibit its binding with NO.

Vascular effects of halothane and isoflurane: cGMP dependent and independent actions

This study investigated the effects of halothane and isoflurane on cGMP-dependent and independent regulation of vascular contraction of the isolated rat aorta and on NO-stimulated soluble guanylate cyclase (sGC) isolated from the perfused rat liver. For the studies of the aorta, isometric tension of isolated rings, with and without, endothelium was recorded and cGMP content measured. ACh was used to initiate endothelial-dependent relaxation of norepinephrine (NE)-contracted rings while NO was used to directly stimulate isolated aortic ring sGC which catalyzes the isolated aortic ring formation of cGMP. Both halothane and isoflurane interfered with ACh and NO relaxations and with NO-stimulated increases in cGMP. Halothane was more potent, having significant attenuating effects at 0.34 mM (1 MAC) and 0.72 mM (2 MAC) while isoflurane had effects only at 0.53 mM (2 MAC). For the isolated sGC studies, a soluble liver fraction was prepared from perfused rat livers. In the absence of NO stimulation, neither halothane nor isoflurane modified the activity of the sGC. However, during NO-stimulation halothane produced significant, concentration-dependent, inhibition of sGC activity over a wide range of NO concentrations. Isoflurane also inhibited sGC activity, but to a lesser extent than halothane. The mechanism whereby the anesthetics could interfere with sGC from liver and blood vessels is unknown. It could result from anesthetic interaction at hydrophobic sites that may exist in GC. However, the results of both the aorta and liver sGC enzyme studies support the suggestion that these anesthetics can compete with NO for its binding site on the ferrous heme of sGC, with chemical structural differences accounting for the potency variations. Both anesthetics also had cGMP independent effects, causing concentration dependent relaxations of NE-contracted vessels without endothelium. Isoflurane was about 5 times more effective at 1 MAC than halothane. Therefore, the net effects of these anesthetics involve the sum of two opposite effects on tension of vessels with intact endothelium: 1) interference with NO-stimulated cGMP relaxation and 2) direct stimulation of relaxation (not dependent on changes in cGMP).

Effects of halothane on EDRF/cGMP-mediated vascular smooth muscle relaxations

BACKGROUND

Halothane has been reported to inhibit endothelium-dependent relaxation in a variety of vessels. These studies were done to determine whether this inhibition is caused by interference with synthesis, release, or action of endothelium-derived relaxing factor (EDRF) on cyclic guanosine monophosphate (cGMP) levels within the vascular smooth muscle.

METHODS

Rat aortic rings were suspended in aerated Krebs solution (37 degrees C) and were contracted to a stable plateau with EC60-70 norepinephrine (NE). Relaxations caused by acetylcholine (ACh; 1 x 10(-8)-1 x 10(-6) M), nitric oxide (NO; 5 x 10(-9)-1 x 10(-6) M), or nitroglycerin (NG; 2 x 10(-9)-3 x 10(-7) M) in rings contracted with NE were compared in the presence and absence of halothane. Tissue cGMP contents were measured using a radioimmunoassay method.

RESULTS

In the presence of halothane (0.5, 1.0, and 2.0 MAC), the ACh-induced relaxations were significantly attenuated in a concentration-dependent manner, an effect that was reversible. Halothane (2 MAC) significantly attenuated NO-induced relaxations at all concentrations and NG-induced relaxations at low concentrations (5 x 10(-9)-3 x 10(-8) M) but not at higher concentrations (1 x 10(-9)-3 x 10(-7) M) in denuded vessels. Nitric oxide-stimulated (5 x 10(-8)-5 x 10(-6) M) cGMP content was significantly attenuated by halothane (2 MAC) at NO concentrations between 1 x 10(-7) and 5 x 10(-6) M.

CONCLUSIONS

Nitric oxide, either endogenous or exogenous, interacts with the enzyme guanylate cyclase to stimulate the production of cGMP. Halothane interfered with the relaxations caused by NO (in rings without endothelium) and decreased the NO-stimulated cGMP content. These results suggest that the site of action of halothane in attenuating endothelium-dependent relaxation in the rat aorta is within the vascular smooth muscle, rather than on the synthesis, release, or transit of the EDRF from the endothelium and that its action may involve an interference with guanylate cyclase activation.

Outbreaks of smallpox due to variolation in China, 1962-1965

In 1985, previously unknown outbreaks of smallpox were uncovered which had occurred in Shanxi Province and Nei Monggol Autonomous Region in northern China during 1962-1965, several years after smallpox transmission was thought to have been interrupted. During field investigation, the authors learned that most of the cases were known to local health officials but had not been officially reported to national authorities. All were among persons who had been variolated or were their close contacts. Variolation is an ancient method of protection against naturally acquired smallpox that was officially proscribed in the early 1950s but was renewed in remote areas when smallpox vaccination activities were interrupted during the three-year famine of 1959-1962, following the "great leap forward" program of 1958. It was found that the variolators in Shanxi Province and Nei Monggol Autonomous Region inoculated persons with the use of powdered smallpox scabs mixed with human milk, and that they obtained fresh supplies of scabs every 6-12 months by variolating relatives and friends. The health authorities responded by capturing the variolators, confiscating their variolation material and equipment, and vaccinating the population. The last known cases occurred in 1965, and the practice of variolation is now believed to be extinct.