Effects of Two 15-min Naps on the Subjective Sleepiness,Fatigue and Heart Rate Variability of Night Shift Nurses

The purpose of this study was to examine the effects of two 15-min naps on nurses who work at night in a three-shift system. Of the 15 nurses who were included as study subjects on a night shift, eight took two short naps (the Nap condition), and seven worked without taking a nap (the No-nap condition) during the night shift. We measured sublingual temperature and the bispectral index (BIS), obtained heart rate and heart rate variability measures from an electrocardiogram (ECG), and evaluated sleepiness and fatigue levels every hour using the Visual Analog Scale (VAS). Both subjective sleepiness and fatigue increased between 4:00 and 5:00, with no significant differences observed between the two groups. However, the low- to high-frequency ratio (LF/HF) in the Nap condition group was found to be significantly lower than in the No-nap condition group. Furthermore, a sudden, brief increase in HF values was observed in the No-nap condition group in the morning. The results of this study suggest that taking two short naps may effectively reduce tension and prevent a brief increase in HF values by suppressing sympathetic nervous activity in the morning.     

Sero-epidemiological survey of hepatitis virus infection in Taiwan: A study in 6863 subjects from the general population

Abstract A sero-epidemiological study was made of 6863 apparently healthy randomly selected volunteers from various parts of Taiwan. It revealed an 18% incidence of hepatitis B surface antigen (HBsAg) carriers amongst the general population, the prevalence being significantly higher in males than females (21.7% vs 14.1%). The Takasago natives showed the highest HBsAg carrier rate (27.0%). Those who are primarily derived from Ming Nan had a significantly higher prevalence (19.0%) than those from Hakka (14.7%) and recent immigrants from Mainland China (14.6%). About one-third of female carriers of child-bearing age in southern Taiwan were positive for e antigen (HBeAg) in a limited study; they may be an important source of HB virus (HBV) infection. The positivity rate for HBeAg was significantly higher in subjects below 40 years of age (36.7%) than those above 40 years (7.5%). There was a significant association between HBsAg positivity and elevated serum transaminase levels, especially in males; 20.3% of carriers had elevated transaminase in comparison with 11.1% of female carriers. Among HBsAg seronegative individuals, the frequency of abnormal transaminase increased with age with an overall abnormality rate of 10.6% in males and 5.0% in females, suggesting that factors other than HBV may also contribute to liver disease in Taiwan. Altogether, 9.3% had elevated transaminase. Out of 82 randomly selected HBsAg carriers who were evenly distributed in geography, serum antidelta antibody was positive in only five men (6.1%), of whom four had a mild elevation of transaminase levels (< 100 KU). The overall positivity rate for anti-hepatitis A (HA) antibody was 93.0% in southern Taiwan, indicating poor sanitation. These findings indicate that HB and HA virus infections are highly endemic in Taiwan and that delta infection is infrequent despite a high prevalence of HB virus infection.     

Clinical, Electrophysiological, and Histopathological Observations in Supraventricular Tachycardia

Fifty patients with supraventricular tachycardia (SVT) underwent clinical electrophysiological studies (EPS), endomyocardial biopsies and cardiac catheterizations. EPS revealed AV nodal reentrant tachycardia (AVNRT) in seven patients, AV reentrant tachycardia utilizing concealed AV bypass tracts (AVR-CBT) in nine patients, AV reentrant tachycardia utilizing AV bypass tracts with ventricular preexcitation (manifest WPW) in 13 patients, sinus nodal or intra-atrial reentrant tachycardia (SNRT or IART) in three patients, atrial flutter (AF) in nine patients, automatic atrial tachycardia (AAT) in five patients, and multifocal atrial tachycardia (MAT) in four patients. According to the clinical observations, three patients with AVNRT (43%), six with AVR-CBT (67%), six with manifest WPW (46%), two with SNRT or IART (67%), eight with AF (89%), two with AAT (40%), and two with MAT (50%) showed other accompanying clinical abnormalities. In all patients who were studied histologically, changes in the myocardium were seen; myocarditic changes, postmyocarditic changes and nonspecific abnormalities were present in six (12%), 15 (30%), and nine (18%) respectively. Myocardial changes were observed in four out of seven cases with AVNRT (57%), in six out of nine with AVR-CBT (67%), in five out of 13 with manifest WPW (38%), in two out of three with SNRT or IART (67%), in six out of nine with AF (67%), in all five cases of AAT (100%), and in two out of four with MAT (50%). Nineteen out of 32 without clinical abnormalities except for arrhythmias (59%) had myocardial changes (six had myocarditic changes, ten had postmyocarditic changes, and three had nonspecific abnormalities). On the other hand, nine out of 21 with myocarditic or postmyocarditic changes were accompanied with various arrhythmias other than SVT (two had SSS, five had AV block or rBBB, and two had VT). Elevated LVEDP was present in 36% of the group with normal myocardium and in 53% of the group with myocardial changes. However, the low EF was shown in no patients with normal myocardium but in 21% of the group with myocardial changes. The low CI was also shown in only 9% of the group with normal myocardium but in 28% of the group with myocardial changes. These results suggest that patients with SVT may exhibit several histopathological changes in the myocardium, even in the absence of any clinical organic heart disease.     

Cathepsin B and D expression in squamous cell carcinoma

To elucidate involvement ol protcinascs in malignancy of keratinocytes. expression ol catbepsin B, a cysteine proteinase. and catbepsin D. an aspartic proteinase. was ascertained in lormalin-lixed paraffin-embedded specimens of nortnal skin, squamous cell carcinoma (SCC). Bowen's disease, seborrboeic keratosis and basal cell carcinoma (BCC). Presence of procalbepsin B and an intermediate form of catbepsin D was coiilirmed by Westerti blolling and enzytne activity analysis. Cathepsin B stained more Intensely In SCC tumour cells tban in normal epidermis: staining patterns were diffuse, grantilar or botb. Diflusc and granular patterns (procatbcpsin B and mature enzyme, respectively) appeared in inner and outer parts of tumour islands, respectively. Five of 20 cases of Bowen's disease sbowed diffuse enhanced catbepsin B expression: 20 cases of seborrhoeic keratosis or BCC did not. Cathepsin D stained intensely in tumour cells of half the SCC cases. The staining manner and distribution of cathepsins B and D was similar in the cytoplasm of cancer cells. No enhanced staining of cathepsin I) was seen in any cases of Bowen's disease, seborrhoeic keratosis. or BCC. Coexistence and localization of active mature forms of cathepsins B and D suggests that cooperation between tbe two enzymes may play an important part in invasion of SCC.     

44株人A组轮状病毒武汉流行株的培养鉴定及其意义

目的对A组轮状病毒武汉流行毒株进行培养增殖并确定其基因型和血清型。材料经RT-PCR确定基因型和ELISA确定VP6亚组血清型后初步判定的57株不常见型、混合型及未确定型别的A组轮状病毒流行毒株。方法MA104细胞分离培养病毒;聚丙烯酰胺凝胶电泳确定电泳型;逆转录巢式聚合酶链反应确定G、P、VP6和NSP4基因型;ELISA确定VP6亚组血清型。结果分离率77.2%(44/57)。分离了一株具备双重亚组血清型特征的人轮状病毒R479。分离后基因混合型、非常见基因型别或非常见G、P组合、不能确定的基因型别及VP6亚组血清混合型的样本数量与分离前相比显著减少。结论轮状病毒流行毒株的分离培养有助于提高其基因分型的敏感性,减少基因分型和血清分型的非特异性反应。     

Aerosolized surfactant reverses respiratory failure in lung–lavaged rats

The effects of surfactant replacement by aerosol inhalation and by bolus instillation were compared in rats with respiratory failure induced by repeated lung lavage. The rats were anesthetized with pentobarbital sodium and mechanically ventilated with 100% oxygen. The Pao₂ of control rats not given surfactant (n = 9) remained below 13 kPa. A bolus instillation of a modified natural surfactant (75 mg kg^-1 b.w. in 1.5 ml–kg^-1 b.w. saline) into the airways rapidly reversed the respiratory failure; the mean Pao₂ value (n = 9) 15–180 min after instillation remained over 50 kPa ( P < 0.05 vs. controls). Inhalation of the aerosolized surfactant for 60 min through an ultrasonic nebulizer delivering 75 mg kg^-1 b.w. of the surfactant into the lungs gradually reversed the respiratory failure. The mean Pao₂ value (n = 9) 15 min after initiation of inhalation was 19.6 kPa (NS vs. controls), but after 60 min it rose to above 43 kPa ( P < 0.05 vs. controls; NS vs. bolus instillation). Treatment with surfactant either by continuous aerosol or by bolus led to significant increases of over 24% in the dynamic lung–thorax compliance. We conclude that aerosolized surfactant reverses respiratory failure induced by lung lavage, although the response is slower than after bolus instillation.