Male Andropause : A Myth or Reality

Male andropause, male climacteric or viropause is a condition in which men suffer from complex symptomatology due to low androgen level with aging. After the age of 40 years testosterone level starts declining and andropause corresponds to the age at which a pathogenic threshold is reached. This review summarizes the etiology, consequences, screening, diagnosis, monitoring of androgen deficiency in aging male (ADAM). The pros and cons of testosterone replacement therapy (TRT) in elderly male have been discussed. Currently oral, transdermal, transbuccal, intramuscular, and subcutaneous implants are available for clinical use. The choice is made by physicians based on therapeutic indication and patient preferences.Key Words: Andropause, Aging male, Testosterone replacement therapy     

即刻或延迟桩腔预备对充填材料封闭根管能力的影响

目的：通过流体传输模型测量根管微渗漏的大小，比较即刻桩腔预备和延迟桩腔预备对充填材料封闭根管尖部能力的影响。方法：90颗牙人下颌直根管前磨牙，逐步后退技术预备根管后，随机选择5颗牙为阴性对照组，5颗为阳性对照组。另80颗被随机分为A、B、C、D4组。所有根管均使用侧向加压技术充填，但A组、B组和阴性对照组的根管封闭剂为AH26，C组和D组的根管封闭剂为ulp Canal Sealer (PCS),阳性对照组不使用根管封闭剂。然后连接于流体传输模型，测定根管微渗漏的量。结果：A组与C组、B组D组之间的根管微渗漏的量没有显著性差异，而延迟桩腔预备组根管内微渗漏量显著大于即刻桩腔预备组。结论：延迟桩腔预备可以削弱充填材料封闭根管的能力。     

Radiofrequency Ablation Mapping with Circumferential Catheter for Paroxys- mal Atrial Fibrillation Originating From the Pulmonary Veins

Objectives To assessed the feasibility and effectiveness of electrophysiological mapping of pulmonary veins with a circumferential 10 - electrode catheter and radiofrequency catheter ablation therapy for patients with paroxysmal atrial fibrillation. Background Standard mapping and ablation of focal sources of atrial fibrillation are associated with very long procedure times and low efficacy. Mapping and ablation pulmonary veins guide with a circular catheter could overcome these limitations. Methods 16 patients [male 11, female 5, mean age (51 ±14. 5) years] with paroxysmal atrial fibrillation refractory to antiarrhythmic drugs were included in this group. A circumferential 10 - electrode catheter was used to pulmonary vein mapping during sinus rhythm or CSd pacing to determine the origin of atrial premature contractions. When the ablative target pulmonary vein was found, the pulmonary vein potentials' distribution and activation were assessment pulmonary veins' ostial ablation was performed at the seg     

The plasma cell labeling index: a valuable tool in primary systemic amyloidosis

The plasma cell labeling index (LI) is of value in predicting prognosis in multiple myeloma. Primary systemic amyloidosis (AL) is a plasma cell dyscrasia that shares many features with myeloma. We obtained bromodeoxyuridine LI on 125 patients who presented with AL, 22 of whom also had overt multiple myeloma. Forty-six patients had a plasma cell LI greater than 0%. Of the 46 patients with an elevated LI, 19 (41%) had multiple myeloma as compared with three (4%) of the 79 patients with an LI = 0 (P less than .0001). A response to chemotherapy was seen in 14 (30%) of 46 patients with an LI greater than 0, as compared with ten (13%) of 79 patients with an LI of 0 (P = .015). The median survival of the high LI group was 14.6 months v 29.8 months for the low LI group (P = .02). In the low LI group, 29% are projected to be alive at 60 months, as compared with 20% in the high LI group. When patients with myeloma were excluded from the analysis, the LI did not predict response but continued to indicate a survival disadvantage (P less than .05). The major utility of the LI was in identifying those patients most likely to have multiple myeloma and those AL patients with a poor prognosis (median survival, 14.1 months).     

Erythropoietin concentration during the development and recovery from iron deficiency in the rat

The concentration of plasma erythropoietin was determined by radioimmunoassay during the progression of and subsequent recovery from iron-deficiency anemia in the rat. During the development of anemia, the plasma erythropoietin level rose as the hemoglobin (Hgb) concentration declined, reaching maximal levels when the Hgb was lowest. During the recovery from iron-deficiency anemia after institution of the control diet, the plasma erythropoietin concentration rapidly declined to baseline or below baseline levels even before the Hgb had completely returned to control values. This early fall in the erythropoietin level was associated with a sustained decrease in blood oxygen affinity (increase in P50). The rise in P50 was associated with an increase in the number of circulating reticulocytes in addition to and independently of an increase in the concentration of 2,3-diphosphoglycerate (DPG) in red cells. Therefore, reticulocytosis may play a part in the recovery from anemia, not only by replenishing the red cell pool but also by temporarily facilitating oxygen delivery to the tissues.     

Identification of normal human peripheral blood monocytes and liver as sites of synthesis of coagulation factor XIII a-chain

Factor XIII is the fibrin-stabilizing factor that covalently cross- links fibrin monomers to form a highly organized, stable fibrin clot. The plasma form of factor XIII is a heterodimer, a2b2, consisting of two a-chains and two b-chains; the intracellular form, such as in platelets and placenta, is a dimer, a2, consisting of a-chains only. The catalytic function of factor XIII, a transglutaminase, resides in the a-chain. To address questions regarding sites of synthesis of factor XIII a-chain, an EcoRI restriction fragment from the protein- coding region of the factor XIII a-chain cDNA was used as a probe for Northern blot analysis. The cDNA probe showed hybridization with a single approximately 4.0-kilobase (kb) message in poly (A)+ mRNA prepared from normal human peripheral blood monocytes and normal human liver. The results demonstrate conclusively that factor XIII a-chains are actively synthesized in circulating monocytes and in liver. To our knowledge, these data represent the first demonstration of synthesis of any blood coagulation factor in primary uncultured and unstimulated monocytes or macrophage cells.     

A K-ras oncogene increases resistance to sulindac-induced apoptosis in rat enterocytes

BACKGROUND & AIMS: Mutations of c-K-ras occur commonly in colonic neoplasms. The aim of this study was to determine how c-K-ras mutations alter the responses to the chemopreventive agent sulindac. METHODS: The parental rat intestinal cell line IEC-18 and c-K-ras-transformed derivatives were treated with sulindac sulfide. Cell cycle distribution was determined by flow-cytometric analysis (fluorescence-activated cell sorter), apoptosis by DNA fragmentation (laddering), flow cytometry, and microscopy, and changes in gene expression by immunoblotting. RESULTS: Sulindac sulfide inhibited cell growth and induced apoptosis in a time- and dose-dependent manner more rapidly in and at lower concentrations in parental cells than ras-transformed cells. Expression of the sulindac sulfide arrested cells in G0/G1, but cells entered apoptosis throughout the cell cycle. Proapoptotic protein Bak was relatively high in untreated parental cells and increased markedly after sulindac sulfide but was low in untreated ras-transformed cells and did not increase after sulindac sulfide. Expression of other Bcl-2 family members was unchanged after sulindac sulfide. However, sulindac sulfide reduced levels of cyclin D1 protein and cyclin E- and cyclin D1- associated kinase activity. CONCLUSIONS: c-K-ras-transformed enterocytes are relatively resistant to sulindac sulfide-induced growth inhibition and apoptosis, which may result from specific reduction of bak expression. (Gastroenterology 1997 Dec;113(6):1892-900)     

Italian Project on Epidemiology of Alzheimer's disease (I.PR.E.A.): study design and methodology of cross-sectional survey

BACKGROUND AND AIMS: The purpose of this paper is to describe the design and diagnostic procedures of the multicenter community-based prospective Italian Project on the Epidemiology of Alzheimer's disease (I.PR.E.A.). The study is aimed at estimating the prevalence and incidence of Alzheimer's disease (AD) in the preclinical phase, examining the natural history of cognitive decline without dementia (mainly AD) in the Italian population, and identifying risk factors or health determinants related or associated with various health outcomes. METHODS: Both cross-sectional and longitudinal phases will be performed in 4800 elderly subjects aged 65-84 years. The sample will be selected from the registries of 12 Italian rural and urban municipalities, with an interval of one year between examinations. The study population will undergo several screening examinations, including personal and informant interviews by means of a structured ad hoc questionnaire, physical and neurological examination, laboratory tests, genetic markers and a neuropsychological battery. Neuroimaging screening will also be carried out in a subgroup of subjects positive for cognitive impairment without dementia. The longitudinal phase will include all subjects who, during the cross-sectional survey, are identified as affected by cognitive impairment without dementia, and will aim at assessing the incidence and natural history of cognitive impairment without dementia and the degree of disease progression from the earliest stage. This is the first systematic prospective study on the preclinical phase of AD in Italy.     

PRACTICAL MANAGEMENT OF PRIMARY VARICOSE VEINS

SUMMARY Varicose veins cause a great deal of morbidity in our population today. Despite the large amount of surgical time spent dealing with the problem, there is still a disappointingly high recurrence rate and many patients are investigated inadequately before surgery. This review considers the assessment of ‘simple’ varicose veins using a combination of tourniquet tests and a hand-held doppler probe. The place of more sophisticated investigative techniques is also discussed, in particular the value of duplex assessment in localising the variably sited sapheno-popliteal junction. Routine stripping of the long saphenous vein to the below-knee level is likely to decrease the recurrence rate of simple, long, saphenous varicose veins.     

异搏停心脏停跳液的延迟复跳现象临床分析与处理

系统观察使用异搏停停跳液的34例体外循环病例,6例(17.6％)在10～38分钟复跳。延迟复跳组和非延迟复跳组间不存在血钙等特异性因素的影响,而受年龄、心脏缺血时间和心脏张力的影响。延迟复跳心脏的功能良好,超微结构保护良好。作者对异搏停液的使用指征和延迟复跳的处理提出了建议。