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We present the first results of the Fermilab National Accelerator Laboratory (FNAL) Muon g-2 Experiment for the positive muon magnetic anomaly a_{µ}≡(g_{µ}-2)/2. The anomaly is determined from the precision measurements of two angular frequencies. Intensity variation of high-energy positrons from muon decays directly encodes the difference frequency ω_{a} between the spin-precession and cyclotron frequencies for polarized muons in a magnetic storage ring. The storage ring magnetic field is measured using nuclear magnetic resonance probes calibrated in terms of the equivalent proton spin precession frequency ω[over Ë]_{p}^{'} in a spherical water sample at 34.7 °C. The ratio ω_{a}/ω[over Ë]_{p}^{'}, together with known fundamental constants, determines a_{µ}(FNAL)=116 592 040(54)×10^{-11} (0.46 ppm). The result is 3.3 standard deviations greater than the standard model prediction and is in excellent agreement with the previous Brookhaven National Laboratory (BNL) E821 measurement. After combination with previous measurements of both µ^{+} and µ^{-}, the new experimental average of a_{µ}(Exp)=116 592 061(41)×10^{-11} (0.35 ppm) increases the tension between experiment and theory to 4.2 standard deviations.
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In this paper analytical expressions are derived to describe the spin motion of a particle in magnetic and electric fields in the presence of an axion field causing an oscillating electric dipole moment (EDM). These equations are used to estimate statistical sensitivities for axion searches at storage rings. The estimates obtained from the analytic expressions are compared to numerical estimates from simulations in Chang et al. (Phys Rev D 99(8):083002, 2019). A good agreement is found.
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BACKGROUND/PURPOSE: With the evolution of assisted fertility and prenatal diagnostic technology, the prevalence of multi-fetal pregnancy increased, followed by the demand for prenatal intervention if genomic aberration was detected. How to distinguish the affected foetus from the normal co-twin before selective fetal reduction is therefore challenging. OBJECTIVES: We retrospectively reviewed the cases of dichorionic twins at our centre during 2004-2018, where selective fetal reduction was requested because one foetus carried a pathogenic genomic aberration. Five cases were enrolled, including three foetuses with trisomy 21, one foetus with microduplication and one foetus with microdeletion disorders. METHOD: We labelled the affected foetus by prenatal ultrasound and rapid molecular tools. For the twins without discriminating sonographic features (e.g., the same gender and no distinct placentae), interphase fluorescence in situ hybridization, rapid microarray and short tandem repeat markers were applied to identify the affected foetus. RESULTS: Selective fetal reduction was allocated accurately for all individuals. Two cases delivered at term, while two delivered preterm, and one developed fetal loss of the co-twin. CONCLUSION: We proposed a working scheme of integrating imaging and molecular techniques to correctly identify the affected co-twin before selective fetal reduction to ensure the accuracy of the identification.
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Aberrações Cromossômicas , Síndrome de Down/diagnóstico , Redução de Gravidez Multifetal/métodos , Gravidez de Gêmeos , Diagnóstico Pré-Natal/métodos , Gêmeos/genética , Adulto , Feminino , Idade Gestacional , Humanos , Hibridização in Situ Fluorescente , Análise em Microsséries , Repetições de Microssatélites , Gravidez , Estudos Retrospectivos , Taiwan , Ultrassonografia Pré-NatalRESUMO
Our aim was to improve the accuracy of measurement of the angulation and the shortening of the height of the ramus in fractures of the mandibular condyle using modified methods. We analysed spiral computed tomography (CT) of 67 unilateral fractures with the OsiriX v 5.0 (©Pixmeo Sarl) and Mimics 19.0 (©2016 Materialise NV, Belgium) and analysed them with SPSS (version 24.0, IBM® SPSS®). Angulation was measured using both the traditional method and our modified method. The results showed significant difference (pâ¯=â¯0.0001), and the values measured with the traditional method were lower, which is consistent with geometric analysis. We repositioned the condylar fragment with computer-aided surgical simulation and measured the shortened ramus. We were unable to find a significant difference between these values and those measured with our modified method (pâ¯=â¯0.053), so the accuracy of the modified method is acceptable. The measurement of the height of the ramus by our modified method is applicable to patients with unilateral, and those with bilateral, fractures. The accuracy in measurement of the major variables of condylar fractures is acceptable in both theory and practice. On the basis of such accurate measurement, more prospective clinical study is needed to find out the most appropriate treatment for condylar fractures.
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Côndilo Mandibular/diagnóstico por imagem , Côndilo Mandibular/lesões , Fraturas Mandibulares/classificação , Fraturas Mandibulares/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Adolescente , Adulto , Idoso , China , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Interpretação de Imagem Radiográfica Assistida por ComputadorRESUMO
AIM: The aim of this study was to analyze the association between poor sleep quality with BMI and health-related physical fitness among college freshmen. METHODS: The participants were college freshmen enrolled in 2011. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). A global PSQI score of 5 and total sleep time (TST) of 7 hours were used to differentiate between poor and good sleepers. Various Body Mass Index (BMI) ranges were used to categorize groups of underweight, normal weight and overweight. Health-related fitness was measured by Sit-And-Reach, Curl-Up, and Run/Walk Tests. RESULTS: A substantial proportion of college students were affected by poor sleep quality. Significantly more females were poor sleepers and had a TST shorter than 7 hrs. No difference in the proportions of participants categorized based on BMI between male and female students. Males generally scored better on health-related physical fitness tests than females. All results of physical fitness tests were significantly correlated with BMI, sleep quality (global PSQI), and TST in both males and females. Pool sleepers were associated with a higher BMI and lower performance of physical fitness. TST was negatively associated with BMI and time length to complete 1600-m or 800-m Run/Walk Test, and positively correlated with the performance of Sit-And-Reach and Curl-Up Tests in both genders. CONCLUSION: Poorer sleep quality and decreased TST were associated with lower performance in health-related physical fitness assessment among college students. Health promotion and educational programs for young adults should emphasize the importance of sleep quality and TST.
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Índice de Massa Corporal , Aptidão Física/fisiologia , Sono/fisiologia , Adolescente , Feminino , Humanos , Masculino , Sobrepeso/fisiopatologia , Privação do Sono/fisiopatologia , Estudantes , Taiwan , Universidades , Adulto JovemRESUMO
We report the growth of needle-like high density quaternary ZnCdSeTe nanowires on oxidized Si(100) substrate using vapor-liquid-solid mechanism by molecular beam epitaxy with an Au-based nanocatalyst. It was found that average length and average diameter of the nanowires were 1.3 microm and 91 nm, respectively. It was also found that the as-grown ZnCdSeTe nanowires exhibit mixture of cubic zinc-blende and hexagonal wurtzite structures. Energy depersive results indicate that composition ratio of our nanowire should be Zn0.87Cd0.13Se0.98Te0.02, which agrees excellently with the designated composition ratio of Zn0.87Cd0.13Se0.98Te0.02.
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Linfangioma/cirurgia , Neoplasias de Tecidos Moles/cirurgia , Adulto , Progressão da Doença , Virilha , Humanos , MasculinoRESUMO
The nomenclature and classification of cutaneous mucinosis is quite complex. An updated classification of idiopathic cutaneous mucinosis (lichen myxoedematosus), included three clinicopathological subsets: a generalized papular and sclerodermoid form, a localized papular form, and an atypical or intermediate form. Cutaneous mucinosis occurring in infancy is very rare. We report a 7-month-old boy with a history of multiple opalescent papules over his fingers and toes since birth. The lesions spontaneously regressed and became indiscernible after 5 years of clinical follow-up. The condition was similar to cutaneous mucinosis of infancy but was also unique because of its spontaneous regression and acral location.
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Mucinoses/congênito , Dermatopatias/congênito , Dedos/patologia , Seguimentos , Humanos , Lactente , Masculino , Mucinoses/patologia , Remissão Espontânea , Dermatopatias/patologia , Dedos do Pé/patologiaRESUMO
In species with hemochorial placentation, such as the mouse and human, trophoblast cells of the implanting blastocyst induce apoptosis and displace endometrial epithelial cells (EEC) to cross the luminal epithelium of the endometrium. Since Fas and Fas ligand (FasL) are expressed in EEC and trophoblast cells respectively and mitogen-activated protein kinases (MAPKs) mediate Fas-induced apoptosis, the roles of Fas/FasL and MAPK signaling in trophoblast-EEC interactions were studied. By co-culturing BeWo trophoblast spheroids with RL95-2 EEC monolayers to mimic blastocyst-endometrial interactions, we found that trophoblast spheroid outgrowth on EEC was significantly enhanced by anti-Fas activating antibody. Since anti-Fas activating antibody had no effect on spheroid expansion on EEC-free culture surfaces, its enhancing effect on spheroid outgrowth on EEC may be mediated by acting on EEC to facilitate trophoblast-induced EEC apoptosis and displacement. Valyl-alanyl-aspartyl-[O-methyl]-fluoromethylketone (VAD-FMK) staining showed that the percentage of apoptotic EEC at the spheroid-EEC interface was markedly increased by anti-Fas activating antibody. Moreover, the pancaspase inhibitor benzyloxycarbonyl-VAD-FMK was able to suppress the enhancing effect of anti-Fas activating antibody on spheroid expansion on EEC. Upon anti-Fas activating antibody stimulation, both p38 MAPK and c-Jun NH(2)-terminal kinase (JNK) were activated. Furthermore, the anti-Fas activating antibody-enhanced EEC apoptosis and spheroid expansion on EEC were significantly inhibited by the p38 MAPK inhibitor SB203580 and JNK inhibitor SP600125. Our results establish that anti-Fas activating antibody could activate p38 MAPK and JNK to induce EEC apoptosis, thereby promoting trophoblast outgrowth on EEC.
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Anticorpos Monoclonais/farmacologia , Apoptose/efeitos dos fármacos , Células Epiteliais/citologia , Proteínas Quinases Ativadas por Mitógeno/metabolismo , Trofoblastos/citologia , Receptor fas/agonistas , Clorometilcetonas de Aminoácidos/farmacologia , Antracenos/farmacologia , Caspases/metabolismo , Linhagem Celular Tumoral , Proliferação de Células/efeitos dos fármacos , Técnicas de Cocultura , Inibidores de Cisteína Proteinase/farmacologia , Implantação do Embrião/fisiologia , Endométrio/citologia , Células Epiteliais/efeitos dos fármacos , Células Epiteliais/metabolismo , Feminino , Humanos , Imidazóis/farmacologia , Proteínas Quinases JNK Ativadas por Mitógeno/antagonistas & inibidores , Proteínas Quinases JNK Ativadas por Mitógeno/metabolismo , Proteínas Quinases Ativadas por Mitógeno/antagonistas & inibidores , Modelos Biológicos , Fosforilação/efeitos dos fármacos , Inibidores de Proteínas Quinases/farmacologia , Piridinas/farmacologia , Trofoblastos/efeitos dos fármacos , Receptor fas/antagonistas & inibidores , Receptor fas/imunologia , Proteínas Quinases p38 Ativadas por Mitógeno/antagonistas & inibidores , Proteínas Quinases p38 Ativadas por Mitógeno/metabolismoRESUMO
Haemophilia A (HA) is an X-linked recessive bleeding disorder caused by various types of pathological defects in the factor VIII gene (F8), which encodes coagulation factor VIII (FVIII). To date, several studies on the spectra of F8 defects have been performed in Western populations, but similar studies in Asian races are scarce. Here, we report the distribution of the mutations within the F8 gene in 31 Taiwanese unrelated HA patients (19 severe and 10 moderate/mild males and two severe females). Of these, 12 (38.7%) and one (3.2%) severe males were genotyped with the recurrent IVS22 and IVS1 inversion, respectively, similar to that in general populations (IVS22: 40-50%; IVS1: 2-5%). The F8 defects in the remaining 18 inversion-negative patients cover a wide spectrum, in which 17 different mutations were identified (10 missense and three nonsense mutations, and two small and two large deletions). Eleven of these mutations are novel: seven caused missense substitutions and four resulted in truncated proteins. To assess the putative pathogenetic impacts of the newly amino acid substitutions, computer analyses were performed based on molecular 3D modelling. The degree of conservation in cross-species FVIIIs and the position in known functional FVIII regions were studied. The novel missense mutations found in our series all occurred at evolutionary conserved residues that may carry a functional importance in our analyses. The results of this study add the short list of Taiwanese/Chinese F8 mutations, and will enhance our understanding of the molecular basis of FVIII function and the mechanism underlying HA.
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Fator VIII/genética , Hemofilia A/genética , Povo Asiático/genética , Códon sem Sentido , Estudos de Coortes , Análise Mutacional de DNA/métodos , Feminino , Deleção de Genes , Genótipo , Humanos , Masculino , Mutação de Sentido Incorreto , FenótipoRESUMO
Embryo implantation is a complex process that requires coordinated trophoblast-endometrial interactions. During implantation, trophoblast cells of the attached blastocyst penetrate the luminal epithelium of the endometrium before invasion into the endometrial stroma. Previous studies demonstrated that calcitonin was actively secreted by rat and human endometrial epithelial cells (EEC) during the implantation window and targeted disruption of endometrial calcitonin expression dramatically decreased embryo implantation rates; however, the role and signal transduction of calcitonin in trophoblast-endometrial interactions remained unclear and are therefore examined in this study. BeWo trophoblast and RL95-2 EEC lines were used because they preserve many properties of their respective normal tissues. We co-cultured BeWo trophoblast spheroids with RL95-2 EEC monolayers to mimic the blastocyst-endometrial interaction, and found that most spheroids quickly attached to EEC monolayers and then progressively expanded, with marked displacement of EEC adjacent to the outgrowing trophoblast cells. Interestingly, pretreatment of EEC monolayers with calcitonin before the addition of spheroids significantly enhanced trophoblast expansion on EEC monolayers. Cytosolic calcium (Ca(2+)) levels in EEC increased rapidly upon exposure to calcitonin, and blockade of Ca(2+) release by BAPTA-AM effectively prevented the promoting effect of calcitonin on trophoblast expansion on EEC. The Ca(2+)-dependent protein kinase C (PKC) was also activated in EEC after calcitonin treatment, and the PKC inhibitors staurosporine and calphostin C could completely abolish calcitonin-induced augmentation of trophoblast expansion on EEC. Our results suggest that calcitonin promotes trophoblastic displacement of EEC through calcium mobilization and PKC activation, thereby facilitating embryo implantation.
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Calcitonina/fisiologia , Sinalização do Cálcio , Implantação do Embrião , Endométrio/fisiologia , Proteína Quinase C/metabolismo , Trofoblastos/fisiologia , Calcitonina/farmacologia , Linhagem Celular Tumoral , Proliferação de Células , Endométrio/citologia , Células Epiteliais/fisiologia , Feminino , Humanos , Proteína Quinase C/antagonistas & inibidores , Esferoides Celulares/efeitos dos fármacos , Esferoides Celulares/fisiologia , Trofoblastos/efeitos dos fármacosRESUMO
The objectives of this paper are to determine effects of different grass species and their harvests on pollutant removal, elucidate impacts on soil characteristics and grass constituents, observe grass yield and quantify nutrient uptake by vegetation in an overland flow system (OLFS). Polluted creek water was applied to eight channels in the OLFS, which were planted with Paragrass, Nilegrass, Cattail, and Vetiver, with each two channels being randomly planted with a given grass species. The grass in one channel was harvested while that in the other channel was not. At a high rate of 27.8 m d(-1) hydraulic loading, the removal efficiencies of conventional pollutants such as BOD, COD, suspended solids (SS), and total coliforms in wastewater are not affected by the type of the grasses species, but those of nitrogen and phosphorus are affected by different species. Overall average removal efficiencies of BOD, COD, SS, ammonia, total nitrogen, total phosphorus and total coliforms through the OLFS are 42%, 48%, 78%, 47%, 40%, 33% and 89%, respectively. The concentration of nitrate, however, increases due to nitrification. Soil characteristics in OLFS have been changed significantly; specific conductivity, organic matter, exchangeable magnesium, extractable copper and zinc in soils all increase with time while pHs decrease. During the winter season, there is a significant accumulation of nitrate in grass with the subsequent reduction during the active growing season (Spring). The contents of nitrate and phosphorus in grass tissue are higher than those of grass in general pastureland, probably due to nutrient luxury uptake by grass. The overall grass yield, growth rate and nutrient uptake are quantified and implication of such high rate OLFS discussed.
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Biodegradação Ambiental , Poaceae/metabolismo , Poluentes do Solo/análise , Poluição Química da Água/análise , Purificação da Água/métodos , Brachiaria/química , Brachiaria/crescimento & desenvolvimento , Brachiaria/metabolismo , Vetiveria/química , Vetiveria/crescimento & desenvolvimento , Vetiveria/metabolismo , Nitrogênio/metabolismo , Poaceae/química , Poaceae/crescimento & desenvolvimentoRESUMO
OBJECTIVE: To determine the frequencies of cryptic subtelomeric rearrangements and 22q11.2 deletion in anomalous growth-restricted fetuses with normal or balanced G-banded karyotypes. METHODS: This was a study of 27 consecutive fetuses at a median gestational age of 26 (range, 19-33) weeks, that had intrauterine growth restriction (IUGR) as well as at least one major structural anomaly, and a normal or balanced G-banded karyotype. The median maternal age was 29 (range, 17-39) years. Fluorescence z in-situ hybridization (FISH) diagnosis of the cultured amniocytes with the probe TUPLE 1, and then the Chromoprobe Multiprobe-T system were used, respectively, to screen for the frequency of 22q11.2 deletion syndrome and subtelomeric rearrangements involving the 41 unique chromosome ends (i.e. excluding the five short arms of acrocentric autosomes (no. 13, 14, 15, 21 and 22)). Those that had suspected deleted subtelomeres were reanalyzed with a specific subtelomeric probe, TelVysion. RESULTS: Of the 27 fetuses, three (11%) were affected with 22q11.2 deletion syndrome and two (7.4%) had subtelomeric deletions (one monosomy 21q22.3, one monosomy 1p36.3). Of the 11 fetuses with congenital heart defects, three (27.3%) had 22q11.2 deletion syndrome and one (9.1%) had monosomy 1p36.3. In the remaining 16 fetuses without congenital heart defects, none had 22q11.2 deletion syndrome. However, one (6.3%) had cryptic rearrangement involving subtelomeres. CONCLUSION: Prenatal subtelomeric FISH screening is technically feasible using cultured amniocytes. We propose that 22q11.2 deletion syndrome and cryptic subtelomere rearrangements may be important etiologies of fetuses with IUGR and at least one structural anomaly, along with a normal karyotype or one that is balanced by traditional G-banding. Fetuses with congenital heart defects and IUGR should undergo FISH to exclude 22q11.2 deletion syndrome. In fetuses with IUGR and at least one major structural anomaly but without congenital heart defects, screening of subtelomeric rearrangements may contribute to further elucidation of the underlying etiology.
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Deleção Cromossômica , Cromossomos Humanos Par 22/genética , Retardo do Crescimento Fetal/genética , Rearranjo Gênico/genética , Adolescente , Adulto , Amniocentese , Estudos de Coortes , Feminino , Feto , Idade Gestacional , Humanos , Recém-Nascido , Cariotipagem , Idade Materna , Gravidez , Diagnóstico Pré-Natal/métodosRESUMO
Physalis peruviana L. (PP) is a medicinal herb widely used in folk medicine. In this study, supercritical carbon dioxide (SFE-CO2) method was employed to obtain three different PP extracts, namely SCEPP-0, SCEPP-4 and SCEPP-5. The total flavonoid and phenol concentrations, as well as antioxidant and anti-inflammatory activities of these extracts were analyzed and compared with aqueous and ethanolic PP extracts. Among all the extracts tested, SCEPP-5 demonstrated the highest total flavonoid (234.63+/-9.61 mg/g) and phenol (90.80+/-2.21 mg/g) contents. At concentrations 0.1-30 microg/ml, SCEPP-5 also demonstrated the strongest superoxide anion scavenging activity and xanthine oxidase inhibitory effect. At 30 microg/ml, SCEPP-5 significantly prevented lipopolysaccharide (LPS; 1 microg/ml)-induced cell cytotoxicity in murine macrophage (Raw 264.7) cells. At 10-50 microg/ml, it also significantly inhibited LPS-induced NO release and PGE2 formation in a dose-dependent pattern. SCEPP-5 at 30 microg/ml remarkably blocked the LPS induction of inducible nitric oxide synthase (iNOS) and cyclooxygenase-2 (COX-2) expression. Taken together, these results suggest that SCEPP-5, an extract of SFE-CO2, displayed the strongest antioxidant and anti-inflammatory activities as compared to other extracts. Its protection against LPS-induced inflammation could be through the inhibition of iNOS and COX-2 expression.
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Anti-Inflamatórios/farmacologia , Antioxidantes/farmacologia , Dióxido de Carbono/química , Physalis/química , Extratos Vegetais/farmacologia , Animais , Anti-Inflamatórios/química , Anti-Inflamatórios/isolamento & purificação , Antioxidantes/química , Antioxidantes/isolamento & purificação , Western Blotting , Linhagem Celular , Sobrevivência Celular/efeitos dos fármacos , Ciclo-Oxigenase 2/metabolismo , Dinoprostona/metabolismo , Relação Dose-Resposta a Droga , Ativação Enzimática/efeitos dos fármacos , Flavonoides/metabolismo , Sequestradores de Radicais Livres/metabolismo , Lipopolissacarídeos/farmacologia , Macrófagos/citologia , Macrófagos/efeitos dos fármacos , Macrófagos/metabolismo , Óxido Nítrico/metabolismo , Óxido Nítrico Sintase Tipo II/metabolismo , Fenol/metabolismo , Extratos Vegetais/química , Extratos Vegetais/isolamento & purificação , Xantina Oxidase/metabolismoRESUMO
Mosaic beta-galactosidase reporter staining patterns in the adult adrenal cortex of 21-OH/LacZ transgenic mice were compared to those observed in mouse chimeras and X-inactivation mosaics, which are known to have a lineage basis. This revealed similar patterns of blue and white radial stripes in all three experimental groups. Each blue stripe may contain one or more blue coherent clones of cells but this was taken into account by correcting the observed stripe numbers for the effects of different proportions of LacZ-positive (blue) and LacZ-negative (unstained) cells between adrenals. The corrected stripe numbers were similar in all three experimental groups, which supports the hypothesis that the stripes in the adrenals of 21-OH/LacZ transgenic mice are formed in a similar way to those in chimeras and X-inactivation mosaics (i.e., they have a lineage basis). This suggests that the 21-OH/LacZ transgenic mouse is likely to be a valid model for studying steroidogenic cell lineage in the adrenal cortex, thereby providing additional support for the centripetal migration hypothesis of adrenocortical cytogenesis.
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Córtex Suprarrenal/citologia , Óperon Lac , Esteroide 21-Hidroxilase/genética , Córtex Suprarrenal/enzimologia , Animais , Linhagem Celular , Quimera , Inativação Gênica , Genes Reporter , Camundongos , Camundongos Transgênicos , Modelos Animais , Modelos Biológicos , Mosaicismo , Coloração e Rotulagem , Cromossomo X , beta-Galactosidase/genética , beta-Galactosidase/metabolismoRESUMO
Taiwan is an island off the southeastern coast of China with total area of roughly 36,000 km2. The geographic position of Taiwan is between 21degrees 45' 25" to 25 degrees 56' 31" north latitude and 119 degrees 18' 3"to 124 degrees 34' 30" east longitude and includes both tropical and subtropical areas. The study was carried out at twenty main reservoirs in Taiwan area from 1994 to 1998. The study revealed that the water quality of most reservoirs gradually deteriorated during the study period. Total phosphorus concentrations over 60 microg/L were observed in 12.5% of these reservoirs in 1994, but in 22.2% of these reservoirs in 1998. Total nitrogen concentrations over 1.0 mg/L were observed in 37.5% of these reservoirs in 1994, but in 94.4% of these reservoirs in 1998. Secchi disc transparency below 2 m was observed in 75% of these reservoirs in 1994, but in 83.3% of these reservoirs in 1998. Chlorophyll a concentrations over 15 mg/m3 were observed in 12.5% of these reservoirs in 1994, but in 27.8% of these reservoirs in 1998. The TN:TP mass ratios (wt/wt) of all the studied reservoirs except Akungting Reservoir, Fongshan Reservoir, and Chengching Reservoir are higher than 16. The study results on nutrient limitation indicated that phosphorus is the primary limiting nutrient in Taiwan reservoirs except Akungting Reservoir, Fongshan Reservoir, and Chengching Reservoir.
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Eutrofização , Fósforo/análise , Abastecimento de Água , Monitoramento Ambiental , Fósforo/metabolismo , Taiwan , Clima TropicalRESUMO
For patients with persistent or invasive gestational trophoblastic disease (GTD), systemic injection of chemotherapy is the treatment of choice if fertility is to be preserved. To prevent serious adverse effects after systemic use and possibly achieve better effects, direct local injection of chemotherapy into the tumor site, especially when in the myometrium, seems a reasonable alternative. A patient with a persistent molar pregnancy with myometrial invasion is presented. A plateau of beta-hCG (human chorionic gonadotropin) level around 550 mIU/mL was noticed for three weeks though systemic methotrexate (MTX) injection and repeat suction curettage had been performed. During the same period, a well-defined invasive complex with multiple vesicles in the myometrium was documented using transvaginal ultrasound (TVUS). Sonar-guided injection to the tumor using 50 mg MTX was performed uneventfully. An obvious shrinkage of the mass and declining beta-hCG level were demonstrated after the procedure. The patient restored her menses after the operation and a fertility evaluation including serial beta-hCG levels and hysterosalpingography showed them to be within the reference ranges. The successful outcome of this case encouraged us to treat localized invasive GTD using direct injection of MTX with the guidance of TVUS. Since no identical cases were found in our review of the English literature, more cases and similar regimens are needed to establish the safety and efficacy of this procedure.
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Antimetabólitos Antineoplásicos/administração & dosagem , Mola Hidatiforme/tratamento farmacológico , Metotrexato/administração & dosagem , Miométrio/patologia , Neoplasias Uterinas/tratamento farmacológico , Adulto , Gonadotropina Coriônica Humana Subunidade beta/análise , Feminino , Humanos , Mola Hidatiforme/diagnóstico por imagem , Mola Hidatiforme/patologia , Injeções Intralesionais , Invasividade Neoplásica , Neoplasia Residual , Gravidez , Ultrassonografia , Neoplasias Uterinas/diagnóstico por imagem , Neoplasias Uterinas/patologia , Curetagem a VácuoRESUMO
Cell-mediated and humoral immune status of free-ranging green turtles (Chelonia mydas) in Hawaii (USA) with and without fibropapillornatosis (FP) were assessed. Tumored and non-tumored turtles from Kaneohe Bay (KB) on the island of Oahu and from FP-free areas on the west (Kona/Kohala) coast of the island of Hawaii were sampled from April 1998 through February 1999. Turtles on Oahu were grouped (0-3) for severity of tumors with 0 for absence of tumors, 1 for light, 2 for moderate, and 3 for most severe. Turtles were weighed, straight carapace length measured and the regression slope of weight to straight carapace length compared between groups (KB0, KB1, KB2, KB3, Kona). Blood was assayed for differential white blood cell count, hematocrit, in vitro peripheral blood mononuclear cell (PBMC) proliferation in the presence of concanavalin A (ConA) and phytohaemagglutinin (PHA), and protein electrophoresis. On Oahu, heterophil/lymphocyte ratio increased while eosinophil/monocyte ratio decreased with increasing tumors score. Peripheral blood mononuclear cell proliferation indices for ConA and PHA were significantly lower for turtles with tumor scores 2 and 3. Tumor score 3 turtles (KB3) had significantly lower hematocrit, total protein, alpha 1, alpha 2, and gamma globulins than the other four groups. No significant differences in immune status were seen between non-tumored (or KB1) turtles from Oahu and Hawaii. There was no significant difference between groups in regression slopes of body condition to carapace length. We conclude that turtles with severe FP are imunosuppressed. Furthermore, the lack of significant difference in immune status between non-tumored (and KB1) turtles from Oahu and Kona/Kohala indicates that immunosuppression may not be a prerequisite for development of FP.