ALPHA-FETOPROTEIN VARIANTS AND THEIR CLINICAL SIGNIFICANCE

The molecular heterogeneity of serum alpha-fe- toprotein (AFP) in 36 patients was studied by lectin affinity-radioimmunoelectrophoresis. Two variants of AFP, concanavalin-A (Con-A) reactive and the Con-A nonreactive, were obtained. AFP in all 13 patients with hepatoma consisted of the two va- riants, but the Con-A reactive variant was the ma jor one. In 8 patients with benign liver disorder, however, only the Con-A reactive variant of AFP was detected. Over 50"70 0f AFP in 5 patients with yolk sac tumor was Con-A nonreactive. Thus, there were three different patterns of AFP variants. The clinical implications are discussed.     

VALUE AND LIMITATIONS OF SINUS NODE FUNCTION TE.ST BY ATRIAL PACING IN SICK SINUS SYNDROME DIAGNOSIS

In order to evaluate the significance of the sinus node function test by transvenous atrial pacing in the diagno,sis of sick sinus syndrome (SSS), sinus node recovery time (SRT), co]rrected sinus node recovery time (CSRT) and total atrio- sinus and sino-atrial conduction time (SACT) are observed in 69 patients including non-SSS group 39 cases and SSS group 30 cases. According to our data, we suggest criteria for sinus node dysfunction as follows. SRT>1,400 ms and/or A-V junctional esca.pe before sinus recovery and;or secondary pause, CSRT>560 ms. total SACT>300 ms. With l item abnormal, the false positive rat.e in the non-SSS group is 7.7c7。 and the false negative rate in the S.SS group 3.30i" with 2 items abnormal, the false positive rate in the non-SSS group Oi and the false negative rate in the SSS grOiup 6.7'70. Atropine test results are compared with that of atrial pacing, 95.8To and 84.2% are compatible with each other in these 2 groups. In order to cut the use of invasive technic to the minimum, we propose performing the atropine test first. Only in those with unexplainable test results should the trial pacing test. be resorted to..     

Preliminary report on AT1727 as a potential radiosensitizer

AT1727 is a derivative of ICRF 154. The purpose of this study was to evaluate its "radiosensitizer" properties. From October 1979 until the end of December 1980, 89 patients with radiation resistant cancers such as soft tissue sarcoma, squamous lung cancer (with large lesion, 6-8 cm diameter) and other cancers had been included in trial. Radiation therapy was carried out using CO60 or 8 Mev Linac. Fifty-five patients had a remarkable objective remission rate of 61.8% (55/89). Eighteen of 30 patients with soft tissue sarcomas obtained obvious remission (60%), and 26 of 38 patients with lung cancer had remission (68.4%). Patients with esophageal cancer (5/6) and nasopharyngeal cancer (5/5) also had good remission rates. The side-effects of this treatment were very mild: anorexia and vomiting were noted in 50% and no significant changes were noted in liver and kidney function tests and blood platelet count. Leucopenia was slight in all but one patient. No difference in the lung fibrosis rate was noted between the two randomized groups. From the results of this study we concluded that AT1727 had some effect as a "radiosensitizer" but much more work is needed to confirm this.     

New complementary perspectives for inpatient physical function assessment: matched clinician-report and patient-report short form measures from the PROMIS adult physical function item bank

Quality of Life Research - To develop two item content-matched, precise, score-level targeted inpatient physical function (PF) short form (SF) measures: one clinician-reported, one...     

Beyond empathy decline: Do the barriers to compassion change across medical training?

Advances in Health Sciences Education - Background: Despite being a mandated, foundational value in healthcare, research on compassion remains limited. Studying the individual, patient, clinical,...     

Engineered NS1 for Sensitive,Specific Zika Virus Diagnosis from Patient Serology

Dengue virus (DENV) and Zika virus (ZIKV) belong to the Flaviviridae family of viruses spread by Aedes aegypti mosquitoes in tropical and subtropical areas. Accurate diagnostic tests to differentiate the 2 infections are necessary for patient management and disease control. Using characterized ZIKV and DENV patient plasma in a blind manner, we validated an ELISA and a rapid immunochromatographic test for ZIKV detection. We engineered the ZIKV nonstructural protein 1 (NS1) for sensitive serologic detection with low cross reactivity against dengue and developed monoclonal antibodies specific for the ZIKV NS1 antigen. As expected, the serologic assays performed better with convalescent than acute plasma samples; the sensitivity ranged from 71% to 88%, depending on the performance of individual tests (IgM/IgG/NS1). Although serologic tests were generally less sensitive with acute samples, our ZIKV NS1 antibodies were able to complement the serologic tests to achieve greater sensitivity for detecting early infections.