Parasitism of monolayer cultures of dog tissue by Histoplasma capsulatum,I preliminary investigations

Summary Monolayer tissue cultures of canine kidney are demonstrated to by susceptible to invasion by yeast-phaseHistoplasma capsulatum. Primary and secondary tissue cultures of canine kidney show different levels of invasion by the pathogen at 24 hours after inoculation; these differences are interpreted as being related to the number of dividing host cells. By 72 hours after inoculation, similar numbers of yeast cells are demonstrable within the host cells of primary and secondary cultures. Essentially identical results were obtained when canine heart tissue cultures were inoculated with y-phaseH. capsulatum.Paper No.713, Department of Botany and Plant Pathology, The Ohio State University, 1735 Neil Avenue, Columbus 10, Ohio; correspondence should be directed to the junior author at the above address.     

A minor source on the discovery of America

The sixteenth century poemDe navigatione Christophori Columbi by L. Gambara (1496–1586?) is here compared with the contemporary sources on C. Columbus's discoveries in order to verify whether C. Columbus through Nicolas Perrenot de Granvelle (1486–1550) and his son, the Cardinal Antoine (1571–1584), was the source of the poem, as stated on thededicatio. It seems that L. Gambara drew the historical events mainly from P.M. d'Anghiera and F. Columbus. However he added some new elements and an interesting early sixteenth century map of Columbus' discoveries (1st to 3rd voyages), probably all collected by Nicolas Perrenot de Granvelle. HenceDe navigatione (…) may be considered a minor source on Christopher Columbus discoveries.     

Responses of serum chemokines to dramatic changes of air pollution levels,a panel study

Abstract

Background: Despite the in vitro and in vivo evidence, studies are limited in evaluating whether chemokines are potential inflammatory mediators in response to air pollution exposure in humans.

Methods: We conducted a panel study coinciding with the Beijing Olympics, when temporary air pollution controls were implemented. We measured a suite of serum chemokines among healthy adults before, during and after the Olympics, respectively. Linear mixed-effect models were used to evaluate changes in chemokine levels over the three time periods.

Results: In response to the 50% drop in air pollution levels during the games, levels of RANTES, MCP-2, and TARC decreased by 25.8%, 20.9% and 35.3%, respectively (p?<?0.001) from pre-Olympics, and then increased by 45.8%, 34.9% and 61.5%, respectively (p?<?0.001) after the games when air pollution levels went up again. Similar patterns were observed in subgroup analyses by sex, age, smoking and body mass index. GRO-α and IL-8 decreased significantly during the games (22.5% and 30.4%), and increased non-significantly after the games. Eotaxin-1 only increased significantly from during- to post-games.

Conclusions: The strongest associations with air pollution levels were observed among RANTES, TARC and MCP-2. Those chemokines may play important roles in the air pollution-induced inflammatory pathway.     

基于加速康复外科理念的前交叉韧带重建术中麻醉方式的选择

摘要 目的：基于加速康复外科理念,比较分析收肌管阻滞和股神经阻滞两组麻醉方式术后早期反应,探讨其在ACL重建术中的应用。方法：选取符合手术条件的88名ACL损伤的患者,随机分为收肌管阻滞组和股神经阻滞组,手术均在全麻下由同一组医生实施,采用自体腘绳肌重建ACL。比较术后早期2h,4 h,8 h,24 h和48 h患者静息和主动活动时VAS评分;患者首次主动直腿抬高时间;首次自主下地时间;48 h内追加盐酸哌替啶的的人次数;以及不良反应的例数。分析比较两组麻醉方式在术后早期的不同。结果：收肌管阻滞组患者在术后首次直腿抬高的时间和首次自主下地时间两方面与股神经阻滞组相比较,差异有统计学意义（P＜0.05）;两组患者在术后2 h,4 h,8 h,24 h和48 h静息和主动活动时疼痛程度以及48 h内追加盐酸哌替啶的人次数和不良反应的例数之间差异无统计学意义（P＞0.05）。结论：收肌管阻滞能够满足ACL重建术后的早期康复需要,在术后早期对股四头肌的影响较小,有助于患者早期康复,是一种安全、有效的麻醉方式。     

Destructive Thyroiditis Followed by Hypothyroidism Associated with Infliximab Therapy

ObjectiveTo present the rare case of a patient who developed destructive thyroiditis accompanied by transient thyrotoxicosis resulting from infliximab therapy for the treatment of psoriasis.MethodsThe clinical presentation and management of a case with infliximab-associated thyroiditis is described with a brief review of the literature.ResultsA 57-year-old male who suffered from psoriasis was treated with infliximab therapy for 4 years. Thyroid function tests were normal before infliximab therapy. When the patient presented in our clinic, he had thyrotoxicosis and was using propylthiouracil. A 99m Technetiumpertechnetate thyroid scintigraphy scan showed no visualization of either thyroid lobe or decreased thyroid iodine uptake. Thyroid-stimulating hormone (TSH) receptor antibody, thyroid peroxidase antibody (anti-TPO Ab) and thyroglobulin antibody (anti-Tg Ab) were negative. Thyroid ultrasonography revealed a heterogeneous thyroid gland without nodules. After stopping propylthiouracil therapy, we advised monitoring of his thyroid function tests in the following weeks, and infliximab therapy for psoriasis was continued. Four weeks later, his thyroid function tests showed an elevated TSH level with normal levels of free triiodothyronine and thyroxine (FT3 and FT4, respectively), and levothyroxine treatment was administered to the patient. Thyroid function tests normalized after levothyroxine treatment. One year later, infliximab therapy was stopped because of clinical remission. Simultaneously, levothyroxine treatment was also stopped. His thyroid function tests were normal 6 weeks after the cessation of levothyroxine treatment.ConclusionTo our knowledge, the present report is the third infliximab-associated thyroid disorder case. Periodic follow-up of thyroid function tests is necessary during infliximab therapy. (Endocr Pract. 2014;20:e207-e210)     

Postmortem Diagnosis of Diabetic Ketoacidosis Presenting as the "Dead-in-Bed Syndrome"

Objective:To report a case of a young male with type 1 diabetes mellitus found dead in his bed, initially assumed to have died from hypoglycemia (i.e., the “dead in bed” syndrome). However, his autopsy findings revealed that diabetic ketoacidosis (DKA) was the cause of death.MethodsWe present the laboratory and autopsy findings of the patient, highlighting the importance of laboratory analyses of the vitreous humor and microscopy of kidney tissue when investigating the cause of sudden death in patients with type 1 diabetes.ResultsA 25-year-old healthy male with type 1 diabetes on continuous subcutaneous insulin infusion therapy was found dead in his undisturbed bed. An autopsy included vitreous humor analyses. His results were as follows: glucose of 755 mg/dL (reference range 70-105 mg/dL), anion gap > 36 mEq (reference range 4-12 mEq/L), elevated acetone at 66 mg/dL (reference range negative), which were consistent with DKA. Renal microscopy demonstrated subnuclear vacuoles in the proximal tubules, 1 of 2 lesions were described as an Armanni-Ebstein lesion, which is a postmortem finding in patients who die from diabetic coma.ConclusionThe most likely cause of death at home in young patients with type 1 diabetes is severe hypoglycemia. However, an autopsy of the present case confirmed DKA based on vitreous humor biochemistry and microscopic examination of the kidneys, which demonstrated the Armanni-Ebstein phenomenon. Analysis of the vitreous fluid and microscopic examination of the kidneys for the presence of Armanni-Ebstein lesion can be used to help determine the cause of death in patients with type 1 diabetes mellitus. (Endocr Pract. 2014;20:e123-e125)     

Análisis de la sedación paliativa en pacientes mayores hospitalizados: efectividad de un protocolo

ObjectiveTo measure changes in the practice of palliative sedation during agony in hospitalised elderly patients before and after the implementation of a palliative sedation protocol.Material and methodsA retrospective before-after study was performed in hospitalised patients over 65 years old who received midazolam during hospital admission and died in the hospital in two 3-month periods, before and after the implementation of the protocol. Non-sedative uses of midazolam and patients in intensive care were excluded. Patient and admission characteristics, the consent process, withdrawal of life-sustaining treatments, and the sedation process (refractory symptom treated, drug doses, assessment and use of other drugs) were recorded. Association was analysed using the Chi² and Student t tests.ResultsA total of 143 patients were included, with no significant differences between groups in demographic characteristics or symptoms. Do not resuscitate (DNR) orders were recorded in approximately 70% of the subjects of each group, and informed consent for sedation was recorded in 91% before vs. 84% after the protocol. Induction and maintenance doses of midazolam followed protocol recommendations in 1.3% before vs 10.4% after the protocol was implemented (P=.02) and adequate rescue doses were used in 1.3% vs 11.9% respectively (P=.01). Midazolam doses were significantly lower (9.86 mg vs 18.67 mg, P<.001) when the protocol was used than when it was not used. Ramsay sedation score was used in 8% vs. 12% and the Palliative Care Team was involved in 35.5% and 16.4% of the cases (P=.008) before and after the protocol, respectively.ConclusionsUse of midazolam slightly improved after the implementation of a hospital protocol on palliative sedation. The percentage of adequate sedations and the general process of sedation were mostly unchanged by the protocol. More education and further assessment is needed to gauge the effect of these measures in the future.     

Differences in the diurnal and nocturnal use of intertidal feeding grounds by Redshank Tringa totanus

Capsule Redshank used more sites and had larger ranges at night than during the day.

Aims To determine whether there were differences in how wintering Redshank used intertidal feeding grounds during the day and night.

Methods The movements of 38 Redshank caught and radiotagged at two neighbouring sites on the Severn Estuary were monitored during four different study periods between January 1997 and October 1999.

Results Individuals used a greater number of sites at night than in the day (on average, two as opposed to one). Kernel home range analyses also indicated that individuals used larger core areas and home ranges at night. In addition, there was a significant difference between the sizes of ranges of birds caught at two neighbouring sites. One foraging site was almost entirely avoided during the day, probably due to disturbance from an adjacent heliport, but was used by the majority of individuals at night when the heliport was unused. This site was rich in invertebrates as a result of the high organic and nutrient input from a sewage outfall pipe. Redshank also used riverine mudflats less during the night, preferring more open mudflats – perhaps to avoid nocturnal predators.

Conclusions Comparison with previous studies suggests that the importance of sites predominantly used at night and the total extent of the areas used by waders may be underestimated by studies that rely on daytime surveys alone. It is important, therefore, that information on nocturnal distributions should be available to inform decisions on site management and protection.     

Retrospective assessment of a single fiducial marker tracking regimen with robotic stereotactic body radiation therapy for liver tumours

AimTo investigate tumour motion tracking uncertainties in the CyberKnife Synchrony system with single fiducial marker in liver tumours.BackgroundIn the fiducial-based CyberKnife real-time tumour motion tracking system, multiple fiducial markers are generally used to enable translation and rotation corrections during tracking. However, sometimes a single fiducial marker is employed when rotation corrections are not estimated during treatment.Materials and methodsData were analysed for 32 patients with liver tumours where one fiducial marker was implanted. Four-dimensional computed tomography (CT) scans were performed to determine the internal target volume (ITV). Before the first treatment fraction, the CT scans were repeated and the marker migration was determined. Log files generated by the Synchrony system were obtained after each treatment and the correlation model errors were calculated. Intra-fractional spine rotations were examined on the spine alignment images before and after each treatment.ResultsThe mean (standard deviation) ITV margin was 4.1 (2.3) mm, which correlated weakly with the distance between the fiducial marker and the tumour. The mean migration distance of the marker was 1.5 (0.7) mm. The overall mean correlation model error was 1.03 (0.37) mm in the radial direction. The overall mean spine rotations were 0.27° (0.31), 0.25° (0.22), and 0.23° (0.26) for roll, pitch, and yaw, respectively. The treatment time was moderately associated with the correlation model errors and weakly related to spine rotation in the roll and yaw planes.ConclusionsMore caution and an additional safety margins are required when tracking a single fiducial marker.     

SYSTEMATICS OF THE ZYGNEMATACEAE (CHLOROPHYCEAE). III. TRANSEAU COLLECTION OF THE ZYGNEMATACEAE: AN OLD COLLECTION WITH MODERN USES

Edgar Nelson Transeau, botanist-ecologist-phycologist, accumulated a worldwide collection of algal specimens for the compilation of a monograph on the algal family Zygnemataceae, published in 1951. Following his death on January 26, 1960 this Collection remained at The Ohio State University, Columbus until 1978 when it was transferred to the University of Arizona, Tucson. A set of glycerine-preserved specimens on microscope slides is the major item of the Collection with the number of species represented as follows: Spirogyra (138), Mougeotia (52), Zygnema (45), Zygnemopsis (16), Sirogonium (9), Debarya (9), Zygogonium (4), Mougeotiopsis (1) and Entransia (1). All specimens of Pleurodiscus, Sirocladium, Temnogametum and Temnogyra are unidentified. With the Transeau Collection it was demonstrated that an old collection need not be an historical relic, but does have continued usefulness. Potential future use is a powerful justification for maintaining seemingly useless collections whose accumulation often represents the expenditure of untold time, effort and money on the part of many persons and institutions worldwide. Further, as man continues to alter his environment and species are destroyed, collections with long histories become increasingly more valuable. Specimens of the Transeau Collection were subjected to modern techniques, not available earlier, resulting in improved characterization of zygospore-wall structure by scanning electron microscopy and the determination of nuclear DNA by cytofluorometry.     

In vitro analysis of varus-valgus laxity of the knee joint: Comparison of clinical evaluation with measurements using a reference motion analysis system

IntroductionNumerous measurement devices can help clinicians during the knee examination. However, manual evaluation still remains routinely used to assess the knee laxities. The present study evaluated how accurate was a clinician for a varus-valgus stress test. We compared the clinician evaluation to the objective measurement of the knee movements during the same test session.MethodsWe studied six fresh-frozen anatomical lower limbs. The clinician performed a varus-valgus stress test in extension and at 25° flexion. The limbs were equipped with intracortical pins in femur and tibia, and spherical retro-reflecting markers were glued on the pins. Objective knees movements were measured by means of a Motion Analysis^® system (Motion Analysis Corporation, Santa Rosa, CA, USA). Two statistical analyses were performed. A single sample t-test was first used to verify the required 25? flexion. Then, a multivariate anova was performed to analyse the varus-valgus laxity under the fixed factors of measurement method and flexion of the knee.ResultsThe results for varus-valgus and total laxity of the clinician always exhibited a greater variability than objective measurements of the device. Test condition is a factor of grouping differences for Valgus and for global mediolateral laxity. Statistical analysis revealed that the objective measurement was able to show a difference between extension and 25° flexion for global mediolateral laxity, whereas the clinician was not.DiscussionThe clinician was relatively accurate in his manual evaluation. However, we demonstrated that a measurement device could clearly help clinician to exhibit differences in laxity. This can be very useful to compare a knee to itself in two successive conditions, e.g., before and after a surgery.     

Hypergravity can reduce but not enhance the gravitropic response ofChara globularis protonemata

Summary The relationship between the position of the statoliths and the direction and rate of tip growth in negatively gravitropic protonemata ofChara globularis was studied with a centrifuge video microscope. Cells placed perpendicularly to the acceleration vector (stimulation angle 90 °) showed a gradual reduction of the gravitropic curvature with increasing accelerations from 1g to 8g despite complete sedimentation of all statoliths on the centrifugal cell flank. It is argued that the increased weight of the statoliths in hypergravity impairs their acropetal transport which is induced when the cell axis deviates from the normal upright orientation. When the statoliths were centrifuged deep into the apical dome at 6g and a stimulation angle of 170 ° the gravitropic curvature after 1 h was identical to that determined for the same cells at 1g and the same stimulation angle. This indicates that gravitropism in Chara protonemata is either independent of the pressure exerted by the statoliths on an underlying structure or is already saturated at 1g. When the statoliths were moved along the apical cell wall at 8g and the stimulation angle was gradually increased from 170 ° to 220 ° the gravitropic curvature reverted sharply when the cluster of statoliths passed over the cell pole. This experiment supports the hypothesis that in Chara protonemata asymmetrically distributed statoliths inside the apical dome displace the Spitzenkörper and thus the centre of growth, resulting in gravitropic bending. In contrast to the positively gravitropic Chara rhizoids, no modifications either in the transport of statoliths during basipetal acceleration (6g, stimulation angle 0 °, 5 h) or in the subsequent gravitropic response could be detected in the protonemata. The different effects of centrifugation on the positioning of statoliths in Chara protonemata and rhizoids indicate subtle differences in the function of the cytoskeleton in both types of cells.Dedicated to Prof. Dr. Zygmunt Hejnowicz on the occasion of his 70th birthday     

Social vulnerability among cancer patients and changes in vulnerability during their trajectories – A longitudinal population-based study

BackgroundIdentification of socially vulnerable cancer patients in the health care system is difficult. Only little is known concerning changes in the patients’ social circumstances during the trajectory. Such knowledge is valuable regarding the identification of socially vulnerable patients in the health care system. The objective of this study was to use administrative data to identify population-based characteristics of socially vulnerable cancer patients and investigate how social vulnerability changed during the cancer trajectory.MethodologyA registry-based social vulnerability index (rSVI) was applied to each cancer patient prior to their diagnosis, and used to assess changes in social vulnerability after the diagnosis.ResultsA total of 32,497 cancer patients were included. Short-term survivors (n = 13,994) died from cancer from one to three years after the diagnosis, and long-term survivors (n = 18,555) survived at least three years after the diagnosis. 2452 (18 %) short-term survivors and 2563 (14 %) long-term survivors were categorized as socially vulnerable at diagnosis, of these 22 % and 33 % changed category to not socially vulnerable during the first two years after the diagnosis, respectively. For patients changing status of social vulnerability, several social and health-related indicators changed, which is in line with the complexity of the multifactorial social vulnerability. Less than 6 % of the patients categorized as not vulnerable at diagnosis, changed to become vulnerable during the following two years.ConclusionDuring the cancer trajectory, social vulnerability may change in both directions. Surprisingly, more patients, who were categorized as socially vulnerable when their cancer was diagnosed, changed status to not socially vulnerable during follow-up. Future research should attempt to increase knowledge on identifying cancer patients, who experience deterioration after the diagnosis.     

Nest-site re-use: Marsh Tit Poecile palustris decisions in a primeval forest

Capsule Re-use is infrequent although birds reproduce equally well in re-used and new holes.

Aims To describe frequency of hole re-use by Marsh Tits in primeval forest with superabundant holes; to examine how depredation, disturbance, ectoparasites or the low quality of previously used holes influenced birds' decision to switch holes; to assess whether Marsh Tits benefited from re-using holes.

Methods Birds were observed living in undisturbed conditions in a strictly protected part of the Bia?owie?a National Park (Poland) during 13 breeding seasons, hole attributes were measured, and observations made of nest fate and bird survival.

Results Marsh Tits re-occupied 35.5% of available holes used the previous year (n = 214). The holes were most often re-used when both birds survived (42%) or when the surviving female was paired to a new male (35%). Holes were re-used less often after brood failure than after successful breeding (13% versus 39%). Other possible factors (ectoparasite infestation, inferior hole quality or a bird being caught at hole) had no effect on the re-occupation frequency. Birds in the retained and new holes bred at the same time, laid the same number of eggs, and had almost identical nesting success (78% versus 76%).

Conclusion Superabundant holes in the primeval forest allow Marsh Tits to change holes frequently. Similar outcomes of breeding in the re-used and new holes indicate that choices made by the birds are largely neutral, i.e. there is no strong selection pressure for or against hole re-use.     

Efficacy of handrubbing with alcohol based solution versus standard handwashing with antiseptic soap: randomised clinical trial

ObjectiveTo compare the efficacy of handrubbing with an alcohol based solution versus conventional handwashing with antiseptic soap in reducing hand contamination during routine patient care.DesignRandomised controlled trial during daily nursing sessions of 2 to 3 hours.SettingThree intensive care units in a French university hospital.Participants23 healthcare workers.InterventionsHandrubbing with alcohol based solution (n=12) or handwashing with antiseptic soap (n=11) when hand hygiene was indicated before and after patient care. Imprints taken of fingertips and palm of dominant hand before and after hand hygiene procedure. Bacterial counts quantified blindly.ResultsWith handrubbing the median percentage reduction in bacterial contamination was significantly higher than with handwashing (83% v 58%, P=0.012), with a median difference in the percentage reduction of 26% (95% confidence interval 8% to 44%). The median duration of hand hygiene was 30 seconds in each group.ConclusionsDuring routine patient care handrubbing with an alcohol based solution is significantly more efficient in reducing hand contamination than handwashing with antiseptic soap.

What is already known on this topic

To improve compliance with hand hygiene during patient care, handrubbing with an alcohol based solution has been proposed as a substitute for handwashing because of its rapid action and accessibilityExperimental studies show that handrubbing is at least as effective as medicated soap in reducing artificial contamination of handsMany healthcare workers still have reservations regarding its efficacy and are reluctant to use this technique

What this study adds

When used in routine practice, handrubbing with an alcohol based solution after contact with patients achieved a greater reduction in bacterial contamination of hands than conventional handwashing with medicated soap     

以N-甲基吡咯烷酮(NMP)为电子供体进行反硝化的可行性及实验研究

【目的】利用N-甲基吡咯烷酮(N-methylpyrrolidone, NMP)作为电子供体进行反硝化实验,以实现废水资源化。【方法】分别将NMP废水和葡萄糖作为电子供体加入到模拟的城市污水处理尾水中进行反硝化,比较2种电子供体去除硝酸盐的规律。同时考查NMP在反硝化过程中的氮素释放规律,并对所释放的氮素进行后续处理。最后再对它们作为电子供体时的反硝化污泥采用高通量测序,从微生物群落的角度分析NMP作为电子供体时其作用机理是否相同。【结果】当以NMP为电子供体时,硝酸盐氮的去除速率比葡萄糖为电子供体时要快67%。在8 h的反硝化结束后,剩余的硝酸盐氮、累积的亚硝酸盐氮和NMP本身所释放氨氮之和的总氮,与葡萄糖为电子供体时相近。【结论】NMP废水可以作为电子供体用于城镇污水处理厂的深度脱氮。对2种碳源所驯化的反硝化污泥样品进行高通量分析表明,NMP与葡萄糖作为电子供体用于反硝化反应时,相关的作用机理是不同的。该项研究结果对利用含氮杂环化合物作为电子供体进行反硝化具有重要的理论指导意义。     

High frequency vibration conditioning stimulation centrally reduces myoelectrical manifestation of fatigue in healthy subjects

ObjectiveVibration conditioning has been adopted as a tool to improve muscle force and reduce fatigue onset in various rehabilitation settings. This study was designed to asses if high frequency vibration can induce some conditioning effects detectable in surface EMG (sEMG) signal; and whether these effects are central or peripheral in origin.Design300 Hz vibration was applied for 30 min during 5 consecutive days, to the right biceps brachii muscle of 10 healthy males aged from 25 to 50 years. sEMG was recorded with a 16 electrode linear array placed on the skin overlying the vibrated muscle. The test protocol consisted of 30% and 60% maximal voluntary contraction (MVC) as well as involuntary (electrically elicited) contractions before and after treatment.ResultsNo statistically significant differences were found between PRE and POST vibration conditioning when involuntary stimulus-evoked contraction and 30% MVC were used. Significant differences in the initial values and rates of change of muscle fibre conduction velocity were found only at 60% MVC.Conclusions300 Hz vibration did not induce any peripheral changes as demonstrated by the lack of differences when fatigue was electrically induced. Differences were found only when the muscle was voluntarily fatigued at 60% MVC suggesting a modification in the centrally driven motor unit recruitment order, and interpreted as an adaptive response to the reiteration of the vibratory conditioning.     

Clinical implementation of a Monte Carlo based treatment plan QA platform for validation of Cyberknife and Tomotherapy treatments

PurposeThe main focus of the current paper is the clinical implementation of a Monte Carlo based platform for treatment plan validation for Tomotherapy and Cyberknife, without adding additional tasks to the dosimetry department.MethodsThe Monte Carlo platform consists of C++ classes for the actual functionality and a web based GUI that allows accessing the system using a web browser. Calculations are based on BEAMnrc/DOSXYZnrc and/or GATE and are performed automatically after exporting the dicom data from the treatment planning system. For Cyberknife treatments of moving targets, the log files saved during the treatment (position of robot, internal fiducials and external markers) can be used in combination with the 4D planning CT to reconstruct the actually delivered dose. The Monte Carlo platform is also used for calculation on MRI images, using pseudo-CT conversion.ResultsFor Tomotherapy treatments we obtain an excellent agreement (within 2%) for almost all cases. However, we have been able to detect a problem regarding the CT Hounsfield units definition of the Toshiba Large Bore CT when using a large reconstruction diameter. For Cyberknife treatments we obtain an excellent agreement with the Monte Carlo algorithm of the treatment planning system. For some extreme cases, when treating small lung lesions in low density lung tissue, small differences are obtained due to the different cut-off energy of the secondary electrons.ConclusionsA Monte Carlo based treatment plan validation tool has successfully been implemented in clinical routine and is used to systematically validate all Cyberknife and Tomotherapy plans.     

Robert Alexander Falla K.B.E., C.M.G., M.A., D.Sc., F.R.S.N.Z.

Abstract

On 23 February 1979 Sir Robert Falla collapsed and died at his home in Eastbourne. He was 77. His sudden death came as a great shock to his multitude of friends and colleagues, many of whom were still sharing with Sir Robert a deep sense of loss at the death on 31 May 1978, shortly after the couple's golden wedding anniversary, of his charming wife Molly.     

TCT、HPV检测在宫颈锥切术后复发中的预测价值

目的:评估薄层液基细胞学检查(thinprep cytologic test,TCT)和人乳头瘤病毒(human papillomavirus,HPV)检测在宫颈锥切术后复发中的预测价值。方法:随访531例病理诊断为子宫颈上皮内瘤变(cervical intraepithelial neoplasia,CIN)Ⅱ-Ⅲ级接受宫颈锥切术的患者,分别于术后3、6个月及术后每6-12月随访1次,以TCT及HPV检测作为随访的检测指标,若二者有一项异常,行阴道镜下活组织检查,病理证实存在子颈上皮内瘤变Ⅰ-Ⅲ级者视为复发。采用敏感度、特异度、阳性预测值、阴性预测值表示TCT、HPV检测性能。结果:531例患者中10%(54例)的患者出现不同级别的病变复发。TCT在术后预测病变复发的灵敏度77%,特异度72%;HPV在术后预测病变复发的灵敏度95%,特异度60%,TCT联合HPV预测病变复发的灵敏度100%,特异性80%。术后HPV负荷量100 RLU/PC者较HPV负荷量100 RLU/PC者而言术后病变复发的风险增高,差别有统计学意义(P0.01),术后HPV负荷量100 RLU/PC是锥切术后病变复发的高危因素。结论:使用细胞学联合HPV检测是有效的预测宫颈锥切术后病变复发的方法,术后高HPV负荷量与病变复发相关,并可对术后复发高风险人群进行分流,临床需严密随访。