Diagnostic accuracy and variability of autorefraction by the Tracey Visual Function Analyzer and the Shin-Nippon NVision-K 5001 in relation to subjective refraction

Purpose:  To determine the accuracy of distance autorefractions obtained by two 'open field' devices, the Tracey Visual Function Analyzer and the Shin-Nippon NVision-K 5001, by comparison with subjective refraction.
Methods:  Both eyes of 50 healthy phakic participants underwent subjective refraction. Autorefractions were then performed on undilated pupils using the Tracey and a modified Shin-Nippon autorefractor and these were repeated within 50 days. Agreement with subjective refraction was calculated for sphere, mean spherical equivalent (MSE) and cylindrical vectors J ₀ and J ₄₅. Intratest and intertest variability were also evaluated.
Results:  The mean age of the participants was 37.4 years. Subjective refraction MSE ranged from −6.25 D to +3.62 D, mean −0.49 D ± 1.79 D. Bias between subjective refraction and Tracey was −0.001 D, +0.045 D, +0.017 D, and −0.015 D for sphere, MSE, J ₀ and J ₄₅ respectively; these were not significant. Bias between subjective refraction and Shin-Nippon was +0.004 D, +0.033 D, +0.106 D, and −0.021 D; only the J ₀ vector was significantly different ( p  < 0.0001) although this difference was small. Intratest variability for Tracey was low, measured at 0.189 D for sphere and 0.178 for MSE, and for the Shin-Nippon 0.099 D and 0.086 D respectively. Tracey intertest variability revealed small, statistically significant bias for sphere and MSE (+0.071 D and +0.070 D, p  = 0.011, 0.013). Shin-Nippon reproducibility showed no significant bias.
Conclusions:  Autorefraction measurements captured by both the Tracey and Shin-Nippon devices agree well with subjective refraction. The Shin-Nippon shows lower intratest variability.     

Salivary gland malignancy with divergent differentiation: is it a teratocarcinosarcoma?

Four poorly differentiated malignant lesions occurred in a 60-year-old Chinese male in the nasal cavity, submandibular gland, a lymph node in the neck, and the mandible. These malignant lesions developed within an 8-year period and each showed distinctive histological features. Among these malignant lesions, the neoplasm in the submandibular gland presented variegated histological and immunohistochemical (IHC) features and posed a diagnostic challenge in interpretation. Based on microscopic and IHC findings, we believe the diagnosis of teratocarcinosarcoma is justified for the submandibular neoplasm and the metastasis in the lymph node. The pathological features and diagnoses of these malignant lesions are discussed.     

Differential generation of class I H-2D- versus H-2K-restricted cytotoxicity against a demyelinating virus following central nervous system infection

Despite the fact that both H-2K and D molecules are up-regulated in the central nervous system (CNS) following Theiler's murine encephalomyelitis virus (TMEV) infection, resistance in this virus model of multiple sclerosis maps exclusively to D. To address this paradox, we examined the ability of the K and D molecules to present viral antigens to cytotoxic T lymphocytes (CTL). Whereas no virus-specific CTL were detected in the CNS of susceptible B10.Q and B10.S mice 7 days post-infection, D-restricted CTL were identified readily in the CNS of resistant B10 animals. There was no evidence of K-restricted CTL in the CNS of B10 mice at day 7 post-infection. The presence of both K- and D-restricted virus-specific CTL in the spleen of immunized B10 mice demonstrates that the exclusive use of D molecules by CTL in the CNS of mice 7 days post-infection is not due to the inability of the K molecules to present viral peptides to lymphocytes. We conclude that the prominent role of the D locus in determining resistance or susceptibility to TMEV-induced demyelination is determined by factors governing the regulation of the immune response, and not by the presence or absence of CTL precursors capable of recognizing viral peptides presented by the K and D antigen-presenting molecules, or by differences in the ability of the K and D molecules to present viral peptides.     

走出低谷──再谈渐进式责任制护理

渐进式责任制护理是据国情产生的一个新生事物。其特征是全员参与，在完成功能制工作之后，每位护士负责一位重危病人的护理。其护理内容完全按照责任制护理进行。其不足之处是人员素质的差异，使责任制护理质量有别。不过，可随着条件的成熟，不断得到改进。     

人碱性成纤维细胞生长因子基因在大肠杆菌中的克隆与表达

应用DNA重组技术将编码人碱性成纤维细胞生长因子（bbFGF）的基因克隆至原核高效表达质粒pBV_(221)的启动子下游。SDS-SAGE、ELISA和NTT活性监测结果表明:该重组质粒pBV-hbFGF在大肠杆菌DH5α中,经42℃诱导后,可表达出有较高生物活性的hbFGF。     

A new method of thoracoscopic sympathectomy in hyperhidrosis palmaris

Summary Although hyperhidrosis palmaris is a benign condition, it may cause considerable psychological, social, and occupational disturbances. There are many conservative measures used to treat hyperhidrosis, but surgical sympathectomy is the only permanent cure. Of the various surgical approaches to the upper thoracic sympathetic ganglia, one must select the approach that combines good functional results and a satisfactory cosmetic outcome with only minor complications. Twenty-one patients (10 men and 11 women) with hyperhidrosis palmaris underwent synchronous bilateral T2 sympathectomy between 1 October 1989 and 30 April 1990. These patients underwent a new method of thoracoscopic sympathectomy without preoperative pneumothorax. All were relieved of excessive sweating in their upper extremities immediately after the operation. In addition, the technique led to significant savings in operation and hospitalization time. We recommend thoracoscopic sympathectomy as the best approach for sympathectomy in cases of hyperhidrosis palmaris.