Impact of Ingested Liquids on 24-Hour Ambulatory pH Tests

A prospective investigation of the impact ofingested liquids on 24-hr pH test scores was conducted.Eighty-two patients contributed 142 samples. The liquidsused were coffee/tea (N = 35), water (N = 32), fruit juice (N = 29), cola (N = 34), and beer (N =12). The pH of cola, juice, and beer are approximately3.0. The parameters studied included: total test time,total drink time, total minutes of pH < 4.0 during drink, minutes of pH < 4.0 10 min beforedrink, and minutes of pH < 4.0 10 min followingdrink. Analysis was performed using one-way ANOVA andrepeated measures. Age of patients, total test time, and total time pH < 4.0 were notsignificantly different (P > 0.05). The total time toconsume the drink was significantly greater (P <0.05) for beer than all other liquids. The total time(7.7 ± 6.0 min) pH < 4.0 for cola wassignificantly different (P < 0.023) than beer (3.3± 3.7 min), tea/coffee (1.4 ± 6.5 min),and water (1.1 ± 2.5 min). The percentage oftotal time pH < 4.0 was not significantly different (P >0.05) among any of the liquids. The percentage of timepH < 4.0 during the drink was the highest for cola(63 ± 47%) and juice (51 ± 57%); water,coffee/tea, and beer were not significantly different (P> 0.05). Although the impact of cola and juice werethe greatest, none of these had an impact that exceeded0.5%. The lack of impact of beer appears to be due to the increased period of time it takes toconsume. We conclude that the impact of ingested fluidsis minimal and can probably be disregarded in mostpatient groups.     

HLA—D抗原的相容性以及封闭因子与习惯性流产的关系的实验研究

运用单向混合淋巴细胞培养的方法分别检测了10例习惯性流产史船娠夫妇间、流产史孕妇和无关第三者(男性)间及9例正常妊娠夫妇间的HLA-D抗原的相容性。结果发现流产史夫妇间的HLA-D抗原相容性大于流产史孕妇和无关第三者(男性)之间及正常夫妇间的HLA-D抗原相容性(P<0.01)。提示夫妇间的HLA-D抗原相容性增大可能是导致习惯性流产的原因之一。同时,在反应体系中分别加入不同孕妇血浆以观察其对单向混合淋巴细胞培养(单向MLC)的影响时发现,流产史孕妇血浆对单向MLC不仅无抑制作用,反而有刺激作用,而正常孕妇血浆对单向MLC有抑制作用。推测正常孕妇血浆中存在特异和/或非特异的封闭因子,而流产史孕妇血浆中缺乏特异和/或非特异的封闭因子。     

艾灸抗高甘油三酯血症脂质过氧化正交试验临床研究

筛选抗脂质过氧化诸指标较好的艾灸穴位、时间、疗程 ,为临床治疗提供依据。结果发现 ,其分别构成了影响 TSOD、Cu、Zn-SOD、Mn-SOD活力及降低 MDA含量诸指标的主要因素 ;取穴以神阙、足三里为优 ;疗程以 1～ 2个月为宜 ;每次每穴艾灸时间多为 1 5分钟以上 ;以每日或隔日 1次施治为佳 ,单次艾灸的时间间隔不宜过长。     

Adhesion of a quartz fibre post to a composite resin core: influence of bonding agents and their curing mode

Fibre-reinforced composite posts are currently used to restore endodontically-treated teeth. Push-out tests were carried out to evaluate the performance of several bonding agents on the retention of an endodontic quartz fibre post to a composite resin core. Five bonding agents were investigated in both self-cure and light-cure modes. Ten experimental groups of 10 posts each were constituted as a function of curing mode and bonding agent. Specimens were mounted in a dedicated Teflon mould. This experimental set-up allowed the determination of true shear strength. One-way ANOVA and Student–Newman–Keuls tests were used for statistical analysis. The bonding strengths ranged from 23.4 MPa to 35.3 MPa. The best results were obtained with a light-cure self-etch bonding agent; in all cases photo-polymerisation led to statistically higher bonding strengths compared to chemical auto-polymerisation. Shear bond strength at the post–adhesive interface was also found to be significantly dependant on the nature of the bonding agent. AdheSe self-etch bonding agent was more effective than etch-and-rinse single-component bonding agents.     

The Effectiveness of Using Interferon-gamma Release Assays in Screening Immigration Employees for Latent Tuberculosis Infection

Abstract

We assessed the prevalence of latent tuberculosis infection in immigration employees and compared two of the screening methods. Using a cross-sectional study design, we administered questionnaires regarding demographics, work, medical history, and tuberculosis risk factors to employees at two immigration facilities. Participants underwent tuberculin skin test (TST) placement and blood collection for the QuantiFERONTB Gold in-Tube (QFT-GIT) assay. Fifty-four employees underwent QFT-GIT and TST placement. All QFT-GIT results were negative, and three employees tested TST positive. Twenty-three (49%) of 47 employees requiring two-step TST testing underwent second TST placement. Return rates for first and second TST reading were 76% and 74%, respectively. The QFT-GIT completion rate was higher than that for TST (100% vs. 39%, P < 0.001). Agreement between TST and QFT-GIT was 94%. Immigration employees had low return rates for their TST reading and second TST placement. Performing the one-visit QFT-GIT has administrative and logistical advantages in this occupational group.     

Response of Human Insulinoma Cells to Extracellular Calcium Is Different from Normal B Cells

The preoperative determination of thelocalization of a small insulinoma is sometimesdifficult using routine imaging techniques. We have usedthe selective arterial calcium injection (SACI) test todetermine the location of the tumor preoperatively. Thepathophysiologic basis of the SACI test is based on theresponsiveness of insulinomas to calcium injected intothe feeding artery. In this study, we demonstrated the in vitro response of the insulinoma cellsto the extracellular calcium challenge by usingprimary-cultured insulinoma cells. Human insulinomacells were obtained from three patients. MIN6 cells(normal pancreatic B cells) were used as a control;their insulin response to various stimuli resembles thatof normal B cells. The insulin secretory dynamics inresponse to extracellular calcium were observed using a perfusion system. Second, the change ofthe concentration of cytosolic free calcium([Ca²⁺]_i) was monitored byfluorometry using fura-2/AM. When the concentration ofextracellular calcium ([Ca²⁺]_o) was changed from 2.54 mM to 10 mM, insulinsecretion from the insulinoma cells was markedlyincreased within 6 min (10- to 18-fold at maximum), andrapidly returned to the basal level; at the same time, [Ca²⁺]_i was immediatelyelevated and reached a peak within 1 min. In contrast,in the MIN6 cells, the insulin secretion and [Ca2+]iwere not significantly changed when[Ca²⁺]_o was switched to 10 mM. The results of these in vitro experiments agreedwith the clinical results of the SACI test. The positiveresponse of the insulinoma to the SACI test is probablydue to the different response of insulinoma cells to the extracellular calcium challengecompared with normal B cells. The role of[Ca²⁺]_i may be important in themechanism underlying the SACI test.     

Improvement in Specificity of [14C]d-Xylose Breath Test for Bacterial Overgrowth

The aim of the study was to determine whetherthe specificity of the [¹⁴C]d-xylose breathtest could be improved, by excluding false-positivetests due to premature colonic metabolism of the[¹⁴C]d-xylose caused by rapid colonictransit. Forty-seven patients with suspected small bowelbacterial overgrowth were investigated by (1) aspirationand culture of duodenal fluid and (2) a[¹⁴C]d-xylose breath test. Those with either a positiveduodenal culture or breath test had a repeat[¹⁴C]d-xylose breath test given with one ofthree transit markers (barium, Gastrografin or^99mTc-labeled tin colloid) to determine if the site of metabolism was inthe small bowel or colon. Fourteen patients had positiveduodenal cultures, four of whom had a negative[¹⁴C]d-xylose breath test, 15 patients had apositive [¹⁴C]d-xylose breath test, three ofwhich were due to colonic metabolism of the xylose.Where transit markers were used, ¹⁴C wasdetectable in the breath and serum before barium hadentered the small bowel, thus the barium did not comigrate withthe xylose. Gastrografin accelerated small boweltransit, leading to malabsorption of the xylose in thesmall intestine and subsequent colonic metabolism of the xylose. ^99mTc-labeled tincolloid had no obvious disadvantages and appeared to bethe marker of choice. The use of a transit markerincreased the specificity of the[¹⁴C]d-xylose breath test from 85% to 94%. The specificity of the[¹⁴C]d-xylose breath test for the detectionof small bowel bacterial overgrowth is improved togreater than 90% by the use of an appropriate transitmarker.     

Back Pain-Inducing Test,a Novel and Sensitive Screening Test for Painful Osteoporotic Vertebral Fractures: A Prospective Clinical Study

To detect painful vertebral fractures (VFs) in back pain populations at risk of osteoporosis, we designed a physical examination test (the Back Pain-Inducing Test [BPIT]) that included three movements: lying supine, rolling over, and sitting up. If back pain is induced during any of these movements, the result is defined as positive, thereby establishing a presumptive diagnosis of painful VFs. Pain severity is quantified using a self-reported numerical rating scale (NRS). The presence or absence of painful VFs is verified by whole-spine magnetic resonance imaging (MRI), the gold standard for final diagnosis. According to the standards for reporting diagnostic accuracy, a real-world, prospective, and observational study was performed on 510 back pain patients (enrolled from a single institute) at risk of osteoporosis. The sensitivity, specificity, and accuracy of the BPIT for identifying painful VFs were 99.1% (95% CI, 97.5% to 99.8%), 67.9% (95% CI, 60.4% to 74.5%), and 89.0%, respectively. The positive and negative predictive values were 86.6% (95% CI, 82.9% to 89.6%) and 97.4% (95% CI, 92.6% to 99.3%), respectively. Cutoff NRS scores for lying supine, rolling over, and sitting up were 3, 0, and 2, respectively. The corresponding area under the receiver operating characteristic curves (AUROCs) of each movement was 0.898 (95% CI, 0.868 to 0.922), 0.884 (95% CI, 0.854 to 0.911), and 0.910 (95% CI, 0.882 to 0.933), respectively. Although the high prevalence of VFs in the enrolled cohort partially limits the external validity of the predictive value in the general population, we conclude that the BPIT is potentially effective for detecting painful VFs in back pain populations at risk of osteoporosis. This test may be used as a stratification tool in decision-making on subsequent imaging procedures: a negative BPIT rules out painful VFs and indicates that an MRI should be spared, whereas a positive BPIT means that an MRI is necessary and is likely to identify painful VFs. © 2019 American Society for Bone and Mineral Research.     

Intraductal Secretin Test Is as Useful as Duodenal Secretin Test in Assessing Exocrine Pancreatic Function

We assessed the clinical usefulness of theintraductal secretin test in order to ascertain whetherit can substitute for the conventional duodenal secretintest. Duodenal juice was obtained with a triple-lumen tube and pure pancreatic juice was obtained byretrograde cannulation of the main pancreatic duct usinga duodenofiberscope. Pancreatic secretion was stimulatedby a bolus intravenous injection of secretin (100 units). The two tests showed comparableinterindividual coefficients of variation, significantlygood correlations, and comparable diagnosticefficiencies. The intraductal secretin test showed noless reproducibility than that of the duodenalsecretin test as reported in the literature. In theintraductal secretin test, secretory volume, peak flowrate, bicarbonate output, and lipase output yielded the best diagnostic efficiency, followed by amylaseoutput and maximal bicarbonate concentration. In theintraductal secretin test, a 10-min collection providedas much information as a 20-min collection. We conclude, therefore, that the 10-minintraductal secretin test is as useful as theconventional duodenal secretin test in assessingexocrine pancreatic function and that the mostdiscriminatory parameters are secretory volume, bicarbonate output, andamylase (or lipase) output.     

Reliability and Measurement error of Active Knee extension Range of Motion in a Modified slump Test Position: A Pilot study

Abstract

The slump test is a tool to assess the mechanosensitivity of the neuromeningeal structures within the vertebral canal. While some studies have investigated the reliability of aspects of this test within the same day, few have assessed the reliability across days. Therefore, the purpose of this pilot study was to investigate reliability when measuring active knee extension range of motion (AROM) in a modified slump test position within trials on a single day and across days. Ten male and ten female asymptomatic subjects, ages 20–49 (mean age 30.1, SD 6.4) participated in the study. Knee extension AROM in a modified slump position with the cervical spine in a flexed position and then in an extended position was measured via three trials on two separate days. Across three trials, knee extension AROM increased significantly with a mean magnitude of 2° within days for both cervical spine positions (P>0.05). The findings showed that there was no statistically significant difference in knee extension AROM measurements across days (P>0.05). The intraclass correlation coefficients for the mean of the three trials across days were 0.96 (lower limit 95% CI: 0.90) with the cervical spine flexed and 0.93 (lower limit 95% CI: 0.83) with cervical extension. Measurement error was calculated by way of the typical error and 95% limits of agreement, and visually represented in Bland and Altman plots. The typical error for the cervical flexed and extended positions averaged across trials was 2.6° and 3.3°, respectively. The limits of agreement were narrow, and the Bland and Altman plots also showed minimal bias in the joint angles across days with a random distribution of errors across the range of measured angles. This study demonstrated that knee extension AROM could be reliably measured across days in subjects without pathology and that the measurement error was acceptable. Implications of variability over multiple trials are discussed. The modified set-up for the test using the Kincom dynamometer and elevated thigh position may be useful to clinical researchers in determining the mechanosensitivity of the nervous system.