Fetal cardiac screening by three- and four-dimensional ultrasound

Objective. The objective of our paper is to show that the spatio-temporal image correlation (STIC) and tomographic ultrasound imaging (TUI) is very convenient and helpful for the fetal screening of complex congenital heart defects (CHD).

Methods. Ultrasound examinations were performed using a Voluson 730 EXPERT or PRO system (GE Medical system, Kretztechnik, Zipf, Austria), and the transabdominal probe (RAB 4-8 MHz or 1-5 MHz) was used to acquire the STIC volumes. Various complex CHD including heterotaxia, ventricular septal defect (VSD), atrio-ventricular septal defect (AVSD), tetralogy of fallot (TOF), transposition of great artery (TGA), hypoplastic left heart syndrome (HLHS) were examined between 20 weeks and 35 weeks. After routine cardiac screening and examination by two-dimensional ultrasound, three- and four-dimensional ultrasound were performed by gray-scaled and color flow mapping. After the examination detailed analysis of CHD were performed by STIC and TUI.

Results. In the case of heterotaxia, STIC and TUI was useful for the detection of stomach and cardiac apex in the different slices. In the case of VSD and AVSD, they were useful for the exact determination of septal defect location. In the cases of TOF, TGA and HLHS, they were helpful for observation of outflow tract and exact diagnosis.

Conclusion. In the screening of complex CHD including heterotaxia, VSD, AVSD, TOF, TGA and HLHS, STIC is very useful and powerful tool.     

Screening for major depression in persons with HIV infection: the concurrent predictive validity of the Profile of Mood States Depression‐Dejection Scale

Major Depressive Disorder (MDD) is among the most prevalent but underdiagnosed psychiatric disorders in persons with HIV infection. Given the known adverse impact of comorbid MDD on HIV disease progression and health‐related quality of life, it is important both for research and for efficient, effective clinical care, to validate existing screening measures that may discriminate between MDD and the somatic symptoms of HIV (such as fatigue). In the current study, we evaluated the concurrent predictive validity of the Profile of Mood States (POMS) Depression‐Dejection scale in detecting current MDD in 310 persons with HIV infection. The Structured Clinical Interview for DSM‐IV (SCID) diagnosis of MDD and the Cognitive‐Affective scale from the Beck Depression Inventory (BDI‐CA) served as comparative diagnostic and severity measures of depression, respectively. Results demonstrated that the POMS Depression‐Dejection scale accurately classified persons with and without MDD SCID diagnoses, with an overall hit rate of 80%, sensitivity of 55%, specificity of 84%, and negative predictive power of 91% using a recommended cutpoint of 1.5 standard deviations above the normative mean. Moreover, the POMS performed comparably to the BDI‐CA in classifying MDD. Findings support the predictive validity of the POMS Depression‐Dejection scale as a screening instrument for MDD in persons with HIV disease. Copyright © 2006 John Wiley & Sons, Ltd.     

间歇性低氧训练对男子赛艇运动员大负荷训练期间生理机能的影响

目的:探讨在大负荷训练期间进行间歇性低氧训练对男子赛艇运动员生理机能的影响。方法:12名男子赛艇运动员分成低氧组和对照组,低氧组在赛前大负荷训练期间进行为期4周、每周5天、每天1小时的间歇性低氧训练,其余日常训练两组相同。实验期间每周测试运动员的睡眠质量、耐缺氧能力以及血红蛋白、血尿素、肌酸激酶等指标。结果:4周间歇性低氧训练后,低氧组运动员血红蛋白含量显著高于对照组,血尿素水平和肌酸激酶活性显著低于对照组;低氧组在耐缺氧实验中血氧饱和度显著高于对照组,心率显著低于对照组;低氧组睡眠质量指标得分显著低于对照组。结论:间歇性低氧训练可以提高男子赛艇运动员大负荷训练期间的耐缺氧能力,改善睡眠质量,间接促进机体在承受大负荷训练负荷时的恢复能力。     

Efficacy of Lung Cancer Screening; Comparison of Results from a Case-Control Study and a Survival Analysis

A case-control study to evaluate the efficacy of lung cancer screening conducted by us showed that lung cancer screening may reduce the mortality of the disease up to 28%. Assuming this efficacy is unbiased, and that the screening rate is 51.6%, which was observed in the control group in the above study, the number of lung cancer deaths prevented by screening in the study period was calculated to be 47 for males and females combined. In the same study population, screen-detected lung cancer patients (N = 207) in the same study period were followed and the 7-year survival rate (46.9%) was compared to the 5-year survival rate (11.3%) obtained by the Osaka Cancer Registry, in which screen-detected lung cancer patients were only 1.8%. The number of lung cancer deaths prevented by screening, estimated by the difference in the above two survival rates, was 74 (95% confidence interval; 55–93). The number of lung cancer deaths prevented by screening estimated from the case-control study was significantly lower than that estimated from the survival analysis. This indicates that the efficacy of lung cancer screening estimated by the case-control study was within the range that could be explained by the actual long-term survivors among the screen-detected patients in the study population.     

Nerve conduction as a means of estimating early post-mortem interval

Summary Methods in current practice for ascertaining time of death are largely based on the cooling of the body after death and are somewhat unreliable. A theoretica relationship is known to exist between the decline in the properties defining nerve conduction and time after death caused by the gradual cessation of metabolic activity in nerves. A number of such properties were measured in rats during life and after death. In most cases the relationship was found to be inconsistent. The chronaxie of the strength duration curve for the sciatic nerve was, however, found to increase consistently and reproducibly in a linear fashion over the first 90 min after death to a plateau value which was maintained beyond 135 min. These findings are discussed as the possible basis of a forensic method of determining the duration of the “post mortem interval” within the first few hours after death.      

Three-Year Prospective Adherence to Three Breast Cancer Screening Modalities

Background.This study prospectively examined rates of adherence to mammography, clinical breast examination (CBE), and breast self-examination (BSE) in a cohort of women over 3 years to determine whether participation in BSE influenced participation in the other two screening modalities.Methods.Women ages 51 and older (n= 450) who attended a small group educational session to learn BSE and to hear about CBE and mammography guidelines were assessed annually by telephone for 3 consecutive years to determine their subsequent breast cancer screening behavior.Results.Annual CBE and mammography screening are highly positively associated. Regular performance of BSE has a modest positive association with both CBE and mammography adherence over time.Conclusions.Women who perform BSE regularly over time may be more likely to adhere to the other breast cancer screening guidelines.     

Mass Screening for Neuroblastoma and Estimation of Costs

ABSTRACT. On the basis of epidemiological data and medical costs for patients with neuroblastoma, we have calculated the cost of mass screening for neuroblastoma with high performance liquid chromatography (HPLC) compared to the cost when it is not performed. If the sensitivity of the mass screening is 80 % and 22 000 infants are screened annually the cost will be 27809000 yen ($191800). If mass screening is not performed, the cost will be 28 446 000 yen ($196 200). The difference in cost (637 000 yen or $4 400) is fairly small. If the sensitivity is 75 % and 16 500 infants are screened, the difference is also small (174000 yen or $1 200). Therefore, mass screening with the HPLC method will not be an undue financial burden. But re-screening at an older age will be done with less financially favorable results, considering that the sensitivity may not be as high as that of the first screening and that mothers are somewhat reluctant about re-screening. The balance of the cost of mass screening by qualitative methods may also be less favorable, since the detection rate is low.     

3H-胸苷酸掺入法对选择前列腺癌化疗方案的价值

目的为临床选择激素难治性前列腺癌(HRPC)的化疗方案提供参考.方法采用3H-胸苷酸(3H-TdR)掺入法检测了20例HRPC细胞对常用化疗药物的敏感性.结果HRPC对单药的体外敏感性依次为足叶乙苷(VP16)＞阿霉素(ADM)、5-氟尿嘧啶(5-FU)、雌二醇氮芥(EMP)＞长春花碱(VLB)＞顺铂(DDP);二药联合可使敏感性进一步提高,依次为EMP加VP1 6、5-FU加ADM＞EMP加VLB＞5-FU加DDP三药联用抑瘤作用更强,EMP加VLB加APM、5 FU加ADM加DDP＞EMP加VLB加DDP.结论3H-TdR掺入法有助于化疗方案的选择,对HRPC以联合化疗效果较好.     

Prevalence of and risk factors for nocturia: Analysis of a health screening program

BACKGROUND: We examined the prevalence of and risk factors for nocturia in Kurashiki city and the surrounding area, a rural area in Japan. MATERIALS AND METHODS: We collected data on 6517 individuals (4568 men and 1949 women) who participated in a multiphasic health screening. We analyzed the relationships between nocturia assessed by a questionnaire (voiding twice or more during night) and other variables including age, hypertension, cardiovascular disease, cerebrovascular disease, chronic obstructive pulmonary disease, diabetes mellitus (DM), chronic renal failure, benign prostatic hyperplasia (BPH), smoking habit and alcohol intake. RESULTS: Overall, 1856 individuals (28.5%) answered that they arose to urinate at least twice during the night. This rate increased with age from 16.5% in individuals younger than 50 to 60.0% in those older than 69. Logistic regression analysis revealed that cohorts of subjects 50-59, 60-69, and 70 years old or over had, respectively, 1.75, 3.35, and 6.21 times the prevalence of nocturia of the 49 years or younger cohort. Hypertension (odds ratio [OR] 1.64) and DM (OR 1.70) were other independent positive risk factors for nocturia. On the other hand, current smokers who smoked 20 or more cigarettes per day were less likely to have nocturia than non-smokers (OR 0.72). In male individuals, BPH was another independent positive risk factor (OR 1.35). Gender was not associated with nocturia. CONCLUSIONS: Although population bias is an important limitation to this study, nocturia is associated with various factors suggesting that multiple approaches are needed to the treatment of patients with nocturia.