Early gastric cancer. Recent experience

Early gastric cancer (EGC) is defined as carcinoma in which malignant invasion is limited to the mucosa or submucosa. Records of pathologic examinations from the Hospital of the University of Pennsylvania show that EGC comprised 6% of all gastric carcinomas diagnosed between 1977 and 1983 (7/118 cases) compared with 8.2% of gastric carcinomas diagnosed between 1965 and 1977 (12/147 cases). Double contrast radiographic techniques and fiberoptic endoscopy became widely available at our institution in 1976. Thus, the application of these techniques to symptomatic patients has not improved our ability to diagnose EGC. In contrast, the incidence of EGC in Japan has risen from 5% to 35% with the widespread use of these diagnostic techniques. This discrepancy can be attributed to mass screening of asymptomatic patients in Japan because of the unusually high prevalence of gastric carcinoma in that country. American radiologists and endoscopists should therefore recognize that they are unlikely to experience a significant increase in the detection of EGC as long as these examinations are performed predominantly on symptomatic patients.     

Behaviour of a population of partially duplicated mitochondrial DNA molecules in cell culture: segregation, maintenance and recombination dependent upon nuclear background

We have studied the dynamics of mitochondrial DNA maintenance and segregation in human cells using serial cybrid transfer of partially duplicated mitochondrial DNA, from a mitochondrial myopathy patient, to two distinct recipient cell types. The results indicate two radically different outcomes dependent upon nuclear background. In one case (lung carcinoma) there is systematic loss of the partial duplication by an implied recombinational mechanism. In another nuclear background (osteosarcoma) the duplicated molecules can survive, having only a marginal effect on mitochondrial respiratory function. Moreover, in the osteosarcoma nuclear background further disturbances of mtDNA maintenance frequently follow from cybrid transfer. These are progressive, catastrophic loss of mtDNA and further rearrangement to generate partially triplicated molecules. The results imply differential expression of nuclear genes regulating mtDNA copy number, replication and recombination in different human cell types.      

O04 Four-Year experience of Pharmacology Teaching in the Integrated Curriculum at Taipei Yang-Ming University

National Yang-Ming University was established in 1971 at Taipei. We mainly train 7- year medical students immediately after high school education. Originally, the 4^th year students received their pharmacology teaching by an intensive course within one semester （4 hours/wk）. We covered all 66 chapters in ＂Basic ＆ Clinical Pharmacology＂, with a total 72 lecture hours. In order to design a problem-based learning course for all the courses of previous 4^th year students, our pharmacology teaching must re-organize in this integrated curriculum from the year of 2001. The major changes include： decreasing total lecture hour （from 72 to 58）, one semester course becoming one-year course （roughly 2 hours/wk）, merely covering 80% of all 66 chapters in the textbook. We did student survey each year and the results will be presented in our presentation. Also, the advantages and disadvantages for this reform will be discussed.     

HIV and risk of venous thromboembolism: a Danish nationwide population‐based cohort study

Objective

The association between HIV infection and the risk of venous thromboembolism (VTE) is controversial. We examined the risk of VTE in HIV‐infected individuals compared with the general population and estimated the impact of low CD4 cell count, highly active antiretroviral therapy (HAART) and injecting drug use (IDU).

Methods

We identified 4333 Danish HIV‐infected patients from the Danish HIV Cohort Study and a population‐based age‐ and gender‐matched comparison cohort of 43 330 individuals. VTE diagnoses were extracted from the Danish National Hospital Registry. Cumulative incidence curves were constructed for time to first VTE. Incidence rate ratios (IRRs) and impact of low CD4 cell count and HAART were estimated by Cox regression analyses. Analyses were stratified by IDU, adjusted for comorbidity and disaggregated by overall, provoked and unprovoked VTE.

Results

The 5‐year risk of VTE was 8.0% [95% confidence interval (CI) 5.78–10.74%] in IDU HIV‐infected patients, 1.5% (95% CI 1.14–1.95%) in non‐IDU HIV‐infected patients and 0.3% (95% CI 0.29–0.41%) in the population comparison cohort. In non‐IDU HIV‐infected patients, adjusted IRRs for unprovoked and provoked VTE were 3.42 (95% CI 2.58–4.54) and 5.51 (95% CI 3.29–9.23), respectively, compared with the population comparison cohort. In IDU HIV‐infected patients, the adjusted IRRs were 12.66 (95% CI 6.03–26.59) for unprovoked VTE and 9.38 (95% CI 1.61–54.50) for provoked VTE. Low CD4 cell count had a minor impact on these risk estimates, while HAART increased the overall risk (IRR 1.93; 95% CI 1.00–3.72).

Conclusion

HIV‐infected patients are at increased risk of VTE, especially in the IDU population. HAART and possibly low CD4 cell count further increase the risk.     

Rapid Preparation of High-Quality Frozen Sections Using a Membrane and Vacuum System Embedding Machine

BACKGROUND A wide variety of embedding techniques have been employed to process frozen sections for Mohs micrographic surgery. Prospective data comparing different techniques are lacking.
OBJECTIVE The purpose of this study was to compare tissue processing times and slide quality using the three embedding techniques.
METHODS Seventy-five consecutive Mohs surgery tissue specimens, measuring 1 cm in diameter, were prospectively randomized to processing with the CryoHist, the Cryocup, or the Miami Special. Tissue preparation times were recorded, and slide quality was evaluated. Tissue specimen preparation was standardized to exclude the use of relaxing incisions or other tissue manipulations. In a separate evaluation, slide quality was retrospectively evaluated for 50 large specimens (>2.5 cm) processed with the CryoHist machine.
RESULTS The mean tissue processing time was 11.4 minutes using the CryoHist, 12.9 minutes using the Cryocup, and 12.6 minutes using the Miami Special. Slide quality, using epidermal edge as a primary end point, was superior with the CryoHist compared to the other methods. For large (>2.5 cm) en bloc Mohs specimens processed using the CryoHist, the slide quality was excellent with 92.3% of epidermal edge obtained.
CONCLUSIONS The fully automated CryoHist embedding machine enables high-quality frozen sections to be processed in less time than the Cryocup or the Miami Special. Slide quality is excellent, even for larger specimens.     

Effects of dietary calcium on atherosclerosis, aortic calcification, and icterus in rabbits fed a supplemental cholesterol diet

Background  

Vascular calcification is implicated in myocardial infarction, instability and rigidity of the aortic wall, and bioprosthetic failures. Although an increase in the calcium (Ca) content in atherogenic diets has been shown to decrease atherosclerosis in rabbits, whether Ca supplementation and deficiency can affect atherosclerosis-related aortic calcification remains unknown.     

Evidence for a novel gene for familial febrile convulsions, FEB2, linked to chromosome 19p in an extended family from the Midwest

Febrile convulsions are a common form of childhood seizure. It is estimated that between 2 and 5% of children will have a febrile convulsion before the age of 5. It has long been recognized that there is a significant genetic component for susceptibility to this type of seizure. Wallace, Berkovic and co-workers recently reported linkage of a putative autosomal dominant febrile convulsion gene to chromosome 8q13-21. We report here another autosomal dominant febrile convulsion locus on chromosome 19p. Linkage analysis in this large multi- generational family gave a maximum pairwise lod score of 4.52 with marker Mfd120 at locus D19S177. Linkage to the chromosome 8 locus was excluded in this family. Haplotype analysis using both affected and unaffected family members indicates that this febrile convulsion gene, which we call FEB2 , can be localized to an 11.7 cM, 1-2 Mb section of chromosome 19p13.3, between loci D19S591 and D19S395.      

世界神经病联合会国际合作共济失调量表介绍

目的:介绍世界神经病联合会国际合作共济失调量表内容。方法:全文翻译世界神经病联合会国际合作共济失调量表,并检索Medline1997-01/2006-10与世界神经病联合会国际合作共济失调量表相关文献,检索词"International Cooperative Ataxia Rating Scale"。结果:世界神经病联合会国际合作共济失调量表是半定量化的神经功能评价量表,可以描述和定量评估典型小脑性共济失调症状。该量表是目前世界上惟一被广泛使用的评价共济失调疾病的神经功能量表,评价项目设置最为科学和齐全。适用于包括脊髓小脑性共济失调、小脑性共济失调以及Friedreich共济失调等多种类型的共济失调疾病。其评估效力已被研究结果所证实,虽然某些方面可能有待完善。在国内,该量表尚未得到相关领域研究者的认识和使用。结论:世界神经病联合会国际合作共济失调量表在国际神经病学相关研究领域得到较广泛的使用,有利于客观科学评估病情和治疗效果,值得在中国推广应用。