Relation of Melatonin to Sleep Architecture in Children with Autism

Children with autism often suffer from sleep disturbances, and compared to age-matched controls, have decreased melatonin levels, as indicated by urine levels of the primary melatonin metabolite, 6-sulfatoxymelatonin (6-SM). We therefore investigated the relationship between 6-SM levels and sleep architecture in children with autism spectrum disorders (ASD). Twenty-three children, aged 4–10 years, completed two nights of polysomnography and one overnight urine collection for measurement of urinary 6-SM excretion rate. Parents completed the Children’s Sleep Habits Questionnaire. We found that higher urinary 6-SM excretion rates were associated with increased N3 sleep, decreased N2 sleep, and decreased daytime sleepiness. The results warrant further examination to examine the effects of supplemental melatonin on sleep architecture and daytime sleepiness.     

Detection of human papillomavirus DNA in human cervical lesions by tissue in situ nucleic acid hybridization

Cervical cancer is one of the most common female cancers in Taiwan. Certain types of human papillomavirus (HPV) are frequently detected in the epithelial precancerous and cancerous lesions of the cervix. By the use of tissue in situ hybridization, we investigated the relationship of various types of HPV (group I, HPV-6 & 11, group II, HPV-16 & 18, group III, HPV-31, 33 & 35) with cervical condyloma, carcinoma as well as precancerous lesions. Group I HPV DNAs were mainly found in cervical condylomatous lesions (2/2) of the cervix and cervical intraepithelial neoplasia I (CIN I) (2/4), but were only occasionally found in CIN II (1/4), CIN III (1/9) or non-keratinized squamous cell carcinoma (1/15). HPV DNAs of groups II and III were mainly detected in lesions of CIN III (5/9) and invasive squamous cell carcinoma (large cell, keratinized type: 4/7; large cell, non-keratinized type: 11/15). HPV DNA sequences were invariably detectable only in the cell nuclei of condyloma or dysplastic epithelium or invasive carcinoma. However, they could not only be detected in the upper layer dysplastic cells and koilocytes but also in the well and poorly differentiated cervical cancer cells. The distribution of HPV DNA positive cells in the carcinomas fell into four different patterns: (1) upper zone and non-invasive regions of the carcinoma (11/22, 50%), (2) basal zone and invasive regions (2/22, 9%), (3) randomly scattered (7/22, 32%), and (4) extensively distributed over the whole tumor lesions (2/22, 9%). Thus, our results are consistent with a strong correlation between the presence of HPV-16, 18, 31, 33 and 35 and malignant conversion of cervical epithelial cells.     

The impact of poverty on educational outcomes for children

Over the past decade, the unfortunate reality is that the income gap has widened between Canadian families. Educational outcomes are one of the key areas influenced by family incomes. Children from low-income families often start school already behind their peers who come from more affluent families, as shown in measures of school readiness. The incidence, depth, duration and timing of poverty all influence a child’s educational attainment, along with community characteristics and social networks. However, both Canadian and international interventions have shown that the effects of poverty can be reduced using sustainable interventions. Paediatricians and family doctors have many opportunities to influence readiness for school and educational success in primary care settings.     

Calcification and ossification of chronic encapsulated intracerebral haematoma: case report.

We report a case of calcified chronic encapsulated intracerebral haematoma (ICH) in a 29-year-old female who presented with progressive left sided weakness and intermittent seizures since childhood. The preoperative magnetic resonance (MR) imaging of the head initially suggested that a partially thrombosed aneurysm or vascular malformation was present. However, no vascular stain was found on the digital subtraction angiography (DSA) of both the carotid and vertebral arteries. The excised mass was histologically diagnosed as a chronic ICH. We traced the patient's medical history and found that at the age of one she sustained a head injury after a fall. So far, to our knowledge, no case of epilepsy secondary to a calcified chronic encapsulated ICH occurring 28 years after head injury has been reported. Calcified chronic encapsulated ICH concomitant with new bone formation within is even rarer. The possible pathogenesis of this case is discussed.     

Equity in the finance of health care: some further international comparisons.

This paper presents further international comparisons of progressivity of health care financing systems. The paper builds on the work of Wagstaff et al. [Wagstaff, A., van Doorslaer E., et al., 1992. Equity in the finance of health care: some international comparisons, Journal of Health Economics 11, pp. 361-387] but extends it in a number of directions: we modify the methodology used there and achieve a higher degree of cross-country comparability in variable definitions; we update and extend the cross-section of countries; and we present evidence on trends in financing mixes and progressivity.     

Sesquiterpene esters of aristolochic acid from the root and stem of Aristolochia heterophylla

Three novel sesquiterpene esters of aristolochic acid, aristoloterpenate-II (2), -III (3), and-IV (4), together with known aristoloterpenate-I (1), were isolated and characterized from the root and stem of Aristolochia heterophylla. Their structures were elucidated by spectroscopic methods. The absolute configuration of these compounds at C-4' was determined as R by circular dichroic studies. These compounds showed cytotoxicity against hepatoma G2, 2, 2, 15 cells.     

Diagnosis of tuberculous pericarditis and treatment without corticosteroids at a tertiary teaching hospital in Taiwan: a 14-year experience.

Tuberculous (TB) pericarditis is a rare but life-threatening form of extrapulmonary tuberculosis. The diagnostic strategy and optimal therapy for TB pericarditis are not well established. We retrospectively analyzed the diagnostic data, clinical characteristics, treatment and outcome in a total of 19 patients with TB pericarditis treated from January 1988 to July 2002. Based on the finding of echocardiography, 8 of these patients were classified as having early stage and 11 as having advanced-stage disease. There were 15 men and 4 women, with a mean age of 65 years (range, 34 to 80 years). All patients received antituberculosis chemotherapy, and all but 2 underwent at least 1 of the following procedures: pericardiocentesis and biopsy, pericardial window placement, and pericardiectomy. None of the patients received corticosteroids concurrently. Of the 8 patients with early-stage TB pericarditis, 3 (37.5%) developed constrictive pericarditis, while of the 7 patients with advanced-stage disease (excluding 4 who had already developed TB constrictive pericarditis at diagnosis), 6 (85.7%) subsequently developed constriction. These findings underscore the importance of pericardiectomy in patients with advanced-stage TB pericarditis. To avoid potentially lethal cardiac tamponade and constrictive cardiomyopathy, clinicians should have a high index of suspicion of TB pericarditis when encountering a patient with pericardial effusion. Histopathologic study of pericardial tissue sample is the key to timely diagnosis of TB pericarditis. The favorable outcomes of patients in this series suggest that a combination of antituberculosis chemotherapy and timely pericardiectomy may be the optimal therapy for patients with TB pericarditis.     

Effect of SACCHACHITIN on keratinocyte proliferation and the expressions of type I collagen and tissue-transglutaminase during skin wound healing

SACCHACHITIN is a skin wound-healing membrane made of residual fruiting body of Ganoderma tsugae. Its effect on proliferating cell nuclear antigen (PCNA) expression in actively proliferating cells, type I collagen expression and tissue remodeling in the healing tissue, and the association of tissue-transglutaminase (t-TGase) with wound healing were investigated by immunohistochemical staining. The results demonstrated that PCNA expressed in keratinocytes since day 1 in the SACCHACHITIN group and persisted during entire healing process. In contrast, it was barely detectable on day 3 in the control group. At keratinocyte layer, the SACCHACHITIN group exhibited more type I collagen than did the control group since day 1. At scar tissue, type I collagen was positively stained in the SACCHACHITIN group since day 7 but not in the control group till day 12. Furthermore, t-TGase was strongly expressed on the inner wall of angiogenic vessels on day 5 of the control group but not on that of the SACCHACHITIN group until day 10. The earlier expressions of PCNA and type I collagen in the keratinocyte layer may lead to accelerated skin wound healing. In addition, the later expression of t-TGase, an indicator of apoptosis, on the inner wall of angiogenic capillaries in the SACCHACHITIN group may indicate a longer period of blood supply to the wound area, thus facilitating wound healing. These observed phenomena might underline the beneficial effects of SACCHACHITIN membrane on rapid wound healing.