Comparison of interferon monotherapy with interferon-lamivudine combination treatment in children with chronic hepatitis B.

AIM: To compare interferon monotherapy with combination treatment using interferon and lamivudine in children with chronic hepatitis B. METHODS: Data from 65 children who had received either interferon-alpha (5 MU/m2 subcutaneous thrice a week for 6 months; n=35; Group 1) or this dose of interferon-alpha for 6 months with oral lamivudine for one year (4 mg/Kg/day, maximum 100 mg/day; n=30; Group 2) were analyzed retrospectively. Complete response was defined as ALT normalization, HBeAg/anti-HBe seroconversion and HBV DNA clearance. RESULTS: ALT normalization rates were similar in Groups 1 and 2 at the end of interferon treatment (13 [38%] and 16 [52%], respectively), at 12 months (19 [56%] and 18 [58%]) and at 24 months (24 [71%] and 23 [74%]). HBV DNA clearance was more frequently observed at 6 months in Group 2 than in Group 1 (19 [63%] versus 7 [20%]; p=0.01), but not at 12 months (19 [63%] versus 17 [49%]) or at 24 months (20 [67%] versus 21 [60%]). Rate of HBeAg/anti-HBe seroconversion was higher in Group 2 at 12 months (18 [60%] versus 11 [31%]; p< 0.05). Rate of complete response was similar in Groups 1 and 2 at 6 months (5 [14%] and 10 [33%], respectively), 12 months (14 [40%] and 17 [57%]) and 24 months (20 [57%] and 19 [63%]). CONCLUSION: Although lamivudine and interferon combination achieved higher initial rates of HBV DNA loss and HBeAg/anti-HBe seroconversion than interferon alone, the final response rates were similar with the two treatments. The combination treatment is therefore not indicated for chronic hepatitis B in children.     

Cor triatriatum dexter, atrial septal defect, and Ebstein's anomaly in an adult given a diagnosis by transthoracic and transesophageal echocardiography: a case report.

Cor triatriatum dexter is a very rare congenital abnormality in which the right atrium is divided into two chambers by a membrane. In this abnormality, there is a high incidence of associated congenital abnormalities, particularly of the right heart. In this case study, a 67-year-old man with Ebstein's anomaly, atrial septal defect, and cor triatriatum dexter is presented and echocardiography is discussed as a noninvasive diagnostic tool.     

Extraskeletal Ewing's sarcoma presenting with multifocal intrathoracic mass lesions associated with mediastinal shift

Extraskeletal Ewing's sarcoma is an uncommon disease that predominantly involves the soft tissues of the trunk or the extremities. This article presents a patient with multifocal intrathoracic mass lesions involving the mediastinum and the lingula associated with mediastinal shift, eventually diagnosed as extraskeletal Ewing's sarcoma.     

Association between serum gamma-glutamyltransferase activity and carotid intima-media thickness

Serum gamma-glutamyltransferase (GGT) activity is a marker of oxidative stress and activity is associated with cardiovascular disease. Carotid intima-media thickness (IMT) is a noninvasive predictor of atherosclerosis. We investigated the association between serum GGT activity and carotid IMT. Fifty-five persons who had normal liver function tests were consecutively enrolled. Carotid IMT was evaluated in the right and left common carotid arteries. The averaged values of carotid IMT and serum GGT activity were compared. Serum GGT activity correlated with carotid IMT (r = .396, P = .003). Serum GGT activities were increased in patients with carotid intimal hyperplasia compared with those without intimal hyperplasia (20.3 ± 11.2 vs 34.3 ± 16.1 U/L; P = .001). Serum GGT activity is associated with carotid IMT. This finding supports the concept that elevated serum GGT activity is a marker of atherosclerosis.     

From the Cover: Sensitive dependence of the motion of a legged robot on granular media

Legged locomotion on flowing ground (e.g., granular media) is unlike locomotion on hard ground because feet experience both solid- and fluid-like forces during surface penetration. Recent bioinspired legged robots display speed relative to body size on hard ground comparable with high-performing organisms like cockroaches but suffer significant performance loss on flowing materials like sand. In laboratory experiments, we study the performance (speed) of a small (2.3 kg) 6-legged robot, SandBot, as it runs on a bed of granular media (1-mm poppy seeds). For an alternating tripod gait on the granular bed, standard gait control parameters achieve speeds at best 2 orders of magnitude smaller than the 2 body lengths/s (≈60 cm/s) for motion on hard ground. However, empirical adjustment of these control parameters away from the hard ground settings restores good performance, yielding top speeds of 30 cm/s. Robot speed depends sensitively on the packing fraction and the limb frequency ω, and a dramatic transition from rotary walking to slow swimming occurs when becomes small enough and/or ω large enough. We propose a kinematic model of the rotary walking mode based on generic features of penetration and slip of a curved limb in granular media. The model captures the dependence of robot speed on limb frequency and the transition between walking and swimming modes but highlights the need for a deeper understanding of the physics of granular media.     

Cor triatriatum dexter in two adult patients

Cor triatriatum dexter, in which the right atrium (RA) is divided into two chambers by a membrane, is a very rare congenital abnormality. In this abnormality, there is a high incidence of associated congenital abnormalities, particularly of the right heart. We presented two men with cor triatriatum dexter. Echocardiography is discussed as a non-invasive diagnostic tool.