Endoscopic review of patients who have had gastric surgery.

Seventy one patients who had had operations on their stomachs over 15 years previously were examined by endoscopy and multiple mucosal biopsy sampling. Sixty six had histologically proved gastritis (56 chronic atrophic gastritis, 10 superficial gastritis), 38 intestinal metaplasia, and 11 epithelial dysplasia. In three cases the epithelial dysplasia was severe (carcinoma in situ). One patient had an infiltrating carcinoma and another, whose biopsy appearances were reported as severe dysplasia, developed a carcinoma of the stomach eight months later. All patients having undergone gastric surgery more than five years previously should be screened endoscopically and any found to have moderate dysplasia subjected to regular endoscopic screening thereafter. Patients with severe dysplasia (carcinoma in situ) should be considered for radical surgery.     

Hepatitis B Virus: From Diagnosis to Treatment

Hepatitis B infection is still a global concern progressing as acute-chronic hepatitis, severe liver failure, and death. The infection is most widely transmitted from the infected mother to a child, with infected blood and body fluids. Pregnant women, adolescents, and all adults at high risk of chronic infection are recommended to be screened for hepatitis B infection. The initial analysis includes serological tests that allow differentiation of acute and chronic hepatitis. Molecular assays performed provide detection and quantification of viral DNA, genotyping, drug resistance, and precore/core mutation analysis to confirm infection and monitor disease progression in chronic hepatitis B patients. All patients with chronic hepatitis B should be treated with antiviral medications and regularly monitored for efficient treatment. The current treatment is based on nucleos(t)ide analogs and pegylated interferons that save lives by decreasing liver cancer death, liver transplant, slow or reverse the progression of liver disease as well as the virus infectivity.Key words: hepatitis B virus (HBV), serology, nucleic acid testing, antiviral treatment     

Model program for screening oral cancers in the Roma population

Oral cancer has been identified as a significant public health threat. It is reported that about 3,800 new cases of oral cancer are diagnosed in Hungary each year with approximately 1,700 associated deaths. Oral cancer is the 6th most common cancer in men. Most oral cancers are preventable; 75% of oral cancers are related to tobacco use, alcohol use, or use of both substances together. While there is insufficient evidence to support or refute the use of visual examination as a method of screening for oral cancer in the general population, screening in high-risk populations is highly recommended. It was presumed that high-risk behavior including tobacco and alcohol use is one of the characteristics of Roma people. The main aim of the study was to elaborate a screening model program for the Roma population to determine risk factors of oral cancer and establish early diagnosis hence to reduce morbidity and mortality. In the program we planned to survey the risk factors in the target population, establish the diagnosis of oral cancer and/or pre-cancer and direct the patients to health care facilities. First we determined the target population in four Hungarian towns with the help of Roma social workers and local public health officers. We assembled a questionnaire on risk factors. Training for Roma social workers and screening personnel was also accomplished. Screening for oral precancerous lesions and cancer and survey the risk factors in the target population were performed at the same time. Patients screened to be positive were referred to specialists. Altogether 1,146 persons, 656 male and 490 female (age 20-77 years, mean 40 years), participated in the screening; 84% of them reported on some kind of complaints. We have got valid data on risk factors in connection with oral cancer. More than fifty percent of participants did not clean their teeth regularly, 75% were smokers, while 45% drunk alcohol regularly. 1,6% of screened participants had oral lesions that did not require referral to a specialist, while 2.3% of the screened subjects had referable oral mucosal lesions including leukoplakia. The overwhelming majority (93%) of participants screened to be positive did not see dentist regularly. As a conclusion, we elaborated a screening model program, which is applicable for disadvantaged (e.g. Roma) population to determine risk factors of oral cancer and establish early diagnosis hence to reduce morbidity and mortality. We surveyed the risk factors in the target population, established the diagnosis of oral cancer and/or pre-cancer lesions and directed the patients to care facilities. We also assisted them to get appropriate long-term care and follow-up. The importance of screening activities targeted on high-risk population was underlined.     

慢性乙型肝炎抗病毒治疗研究进展

乙肝病毒的慢性感染是肝纤维化、肝细胞癌的重要病因,积极有效地抗病毒治疗,可显著改善HBV感染者的生活质量。干扰素、核苷（酸）类药物的抗乙肝病毒疗效已得到全球公认,本文就上述两类药物的研究进展进行综述。     

Emboli from the heart

We now have sufficient evidence to recommend an aggressive program of the detection and treatment of hypercholesterolemia. All adult patients should be screened and evaluated, and treatment decisions should be based on their LDL-cholesterol levels and the presence or absence of other risk factors. Diet therapy should be initiated in motivated patients for three to six months progressing from a qualitative to a quantitative approach. Patients with persistent elevations in their LDL-cholesterol levels who accept drug therapy can be begun on a regimen of nicotinic acid, gemfibrizol or bile acid-binding resins, and, when necessary, lovastatin.     

Acute and chronic antiinflammatory profile of the ivy plant, Hedera helix, in rats.

Hedera helix is a plant well-known as ivy or English ivy, and a member of the Araliaceae family. In the present study, we tested the possible antiinflammatory effects of a crude saponin extract (CSE) and a saponin's purified extracts (SPE) of Hedera helix in carrageenan- and cotton-pellet-induced acute and chronic inflammation models in rats. Both the CSE and SPE of Hedera helix were found to have antiinflammatory effects. The most potent drug screened was indomethacin (89.2% acute antiinflammatory effect), while the most potent extract screened was the CSE of Hedera helix at 100 and 200 mg/kg body wt. doses with 77% acute antiinflammatory effects. For testing chronic antiinflammatory (antiproliferative) effects, the cotton-pellet-granuloma test was conducted. Indomethacin was found to be the most potent drug in the chronic phase of inflammation, with 66% effect. The SPE of Hedera helix was more potent than the CSE in its chronic antiinflammatory effect (60% and 49%, respectively).     

Synthesis and ribonucleotide reductase inhibitory activity of thiosemicarbazones

Ribonucleotide reductase (RR) is an important therapeutic target for anticancer drugs. The structure of human RR features a 1:1 complex of two homodimeric subunits, hRRM1 and hRRM2. Prokaryotically expressed and highly purified recombinant human RR subunits, hRRM1 and hRRM2, were used for holoenzyme-based [(3)H]CDP reduction in vitro assay. Ten new thiosemicarbazones (7-16) were synthesized and screened for their RR inhibitory activity. Two thiosemicarbazones derived from p-hydroxy benzaldehyde (9 and 10) were found to be active but less potent than the standard, Hydroxyurea (HU). Guided by the activity of compounds 9 and 10, 11 new thiosemicarbazones (17-27) derived from p-hydroxy benzaldehyde were prepared and screened for their RR inhibitory activity. All the 11 compounds were more potent than HU.     

Design, synthesis and pharmacological screening of a series of N1-(substituted) aryl-5,7-dimethyl-2-(substituted)pyrido(2,3-d)-pyrimidin-4(3H)-ones as potential histamine H1-receptor antagonists

A series of N1-(substituted)aryl-5,7-dimethyl-2-(substituted)pyrido(2,3-d)pyrimidin-4(3H)-one was designed on the basis of the triangular pharmacophoric requirement of histamine H1-receptor antagonists. The designed series was synthesized by cyclo-condensation of monoaryl thiourea with ethyl cyanoacetate in the presence of dry HCl gas to give N1-(substituted aryl)-2-mercaptopyrimidine-4(3H)-one, which on cyclo-condensation with acetylacetone gave the pyridopyrimidinone. Further methylation of the mercapto group at C-2 with methyl iodide followed by nucleophilic displacement of the methylmercapto group by various amines gave the targeted compounds. All the synthesized compounds were screened for histamine H1-receptor antagonistic activity by the in vitro method of inhibition of the isotonic contraction induced by histamine on isolated guinea pig ileum using cetirizine as a standard drug. All the compounds exhibited potent histamine H1-receptor antagonistic activity with pA2 values from 7.30- 9.75 (cetirizine, pA2 value 9.40). The potent compounds were screened for their in vivo antihistaminic activity by protection of animal from asphyxic shock. The sedative potential of potent compounds was checked on albino mice by photoactometer and they had comparative sedative potential to the standard drug cetirizine. None of the compound exhibited anticholinergic activity in the in vitro rat ileum model.     

Screening for cancer.

Screening has proved effective for only two cancer sites, the breast and the cervix uteri. Only for these, therefore, should screening be a part of routine clinical practice. The degree to which screening is effective depends on whether appropriate groups are screened. For cancer of the breast, current evidence justifies mammographic screening every two years only from the age of 50, continuing at least to the age of 70. The place of breast self-examination and physical examination of the breasts is under investigation, but these procedures should probably be used in all women after the age of 40. For cancer of the cervix, nearly maximal efficacy is obtained by screening sexually active women every three years from the age of 25 to 60. Older women who have not been screened regularly should be screened. Other screening techniques to detect cancers, such as the rectal examination, sigmoidoscopy, and fecal occult blood tests for colorectal cancer, are still experimental. Organizational and other difficulties will prevent screening programs from making a major contribution to reducing overall cancer mortality by the year 2000. If organizational problems can be overcome, however, screening may control invasive cancer of the cervix and make a major contribution in reducing breast cancer mortality in the future.     

Cross Sectional Study Evaluating Routine Contact Investigation in Addis Ababa,Ethiopia: A Missed Opportunity to Prevent Tuberculosis in Children

The 2013 global roadmap for childhood tuberculosis calls for countries to implement contact screening and provide preventive therapy to children younger than 5 years. Therefore, this study designed to evaluate the implementation status of child contact screening and management in the health facilities of Addis Ababa, Ethiopia. Smear positive TB patients living with children attending daily observed treatment at the TB clinic and health care workers providing service were approached to address the study objective. Structured questionnaires were administered to smear positive index cases living with children whether they were requested to bring children age five year and below for TB screening and to health care providers in HIV, TB and child health clinics to assess their knowledge and practice on contact screening and management. Double data entry and analysis was done using EpiData software 3.1. In 27 health centres, 688 smear-positive index tuberculosis patients were approached of whom 203 (29.5%) reported to have children five years and below in their household. A total of 48 (23.6%) index cases had been requested by the health care workers to bring their children for tuberculosis screening and 45 (93.8%) had complied with this request. Of 230 children living with index smear positive tuberculosis patient, 152 (66.1%) were not screened for tuberculosis, 78 (33.9%) children screened, 2 had tuberculosis, 76 screened negative of which 3 (3.8%) received preventive treatment. None of the health care workers indicated to routinely record and report on child contact management. Household child contact screening and preventive intervention was sub-optimal in Addis Ababa. An important opportunity lost to prevent tuberculosis in young children. Training of health care workers, availing simple symptom based screening tool, and proper documentation could improve implementation.     

Synthesis and QSAR studies of pyrimido[4,5-d]pyrimidine-2,5-dione derivatives as potential antimicrobial agents

A number of pyrimido[4,5-d]pyrimidine-2,5-dione derivatives were synthesized and screened for antibacterial and antifungal activities. All the synthesized compounds showed the potent antimicrobial activity. The quantitative structure-activity relationship investigation was applied to find a correlation between the different physicochemical parameters of the compounds studied and their biological activity.     

Synthesis and evaluation of antiplatelet activity of trihydroxychalcone derivatives

In an effort to develop potent antiplatelet agents, a series of trihydroxychalcones was synthesized and screened in vitro for their inhibitory effects on washed rabbit platelet aggregation induced by arachidonic acid (100 microM) and collagen (10 microg/ml). Of five compounds with potent inhibitory effects on arachidonic acid- and collagen-induced platelet aggregation, compound 4e was found to be the most potent. The structure-activity relationships suggested that antiplatelet activity was governed to a greater extent by the substituent on B ring of the chalcone template, and most of the active compounds had methoxy or dimethoxy groups on B ring.     

Shorter-lived workers start foraging earlier

In social insects it is often observed that young workers perform tasks inside the nest and later switch to tasks outside the nest. By doing this the workers maximize their expected longevity, because tasks inside the nest are safe and tasks outside the nest are risky. The optimal strategy of workers should be expected to depend not only on their age but also on their health status if it is associated with reduction of longevity. Here a mathematical model is used to calculate the optimal time of switching between safe and risky tasks in a colony consisting of both healthy and unhealthy workers. The model predicts that unhealthy workers, with shorter longevity, should perform more risky tasks at an earlier age than their healthy nest mates should. The optimal time to switch between safe and risky tasks depends on the proportion of healthy and unhealthy workers in the colony, but the workers need not perceive the health status of their nest mates in order to adopt the optimal strategy. The workers need only perceive their own life expectancy, because the life expectancy of healthy and unhealthy workers should be the same at the time of switching from safe to risky tasks. The model predictions agree with a wide range of empirical data presented in this paper. Workers that are infected, poisoned, injured or affected by other harmful factors start to forage and perform other risky tasks at an earlier age than their healthy nest mates.     

Sources of spores for the possible horizontal transmission of Thelohania solenopsae (Microspora: Thelohaniidae) in the red imported fire ants, Solenopsis invicta

We screened adult and larval secretions and midden piles for the presence of Thelohania solenopsae spores to decipher potential sources for the horizontal transmission of the pathogen in fire ants. Hemolymph samples from both adult and larvae were also screened to rule out hemolymph contamination of samples. In adults, Thelohania spores were found in the crop and the fecal fluids, although only free spores were found in the fecal fluids of adults. In fourth instar larvae, both free and octospores were seen in midgut and the meconium samples. All of the midden pile samples had T. solenopsae spores of both types. Based on these results, we theorize that the pathogen may be horizontally transmitted within a colony by the removal and sharing of meconium of prepupating fourth instar larvae by adult workers and by the adult fecal droppings, and intercolonially by contamination of midden piles or brood raiding.     

Specialization in policing behaviour among workers in the ant Pachycondyla inversa

Most animal societies are non-clonal and thus subject to conflicts. In social insects, conflict over male production can be resolved by worker policing, i.e. eating of worker-laid eggs (WLE) or aggression towards reproductive workers. All workers in a colony have an interest in policing behaviour being expressed, but there can be asymmetries among workers in performing the actual behaviour. Here, we show that workers of the ant Pachycondyla inversa specialize in policing behaviour. In two types of behavioural assays, workers developed their ovaries and laid eggs. In the first experiment, reproductive workers were introduced into queenright colonies. In the second experiment, WLE were introduced. By observing which individuals policed, we found that aggressive policing was highly skewed among workers that had opportunity to police, and that a similar tendency occurred in egg policing. None of the policing workers had active ovaries, so that policing did not incur a direct selfish benefit to the policer. This suggests that policing is subject to polyethism, just like other tasks in the colony. We discuss several hypotheses on the possible causes of this skew in policing tasks. This is the first non-primate example of specialization in policing tasks without direct selfish interests.     

Problems in the control of hypertension in the community.

A hypertension survey was conducted in Montreal to determine the extent, nature and distribution of the control of hypertension. Of the 12 055 persons screened in shopping centres, workplaces and a random sample of homes in four census tracts the hypertension was not controlled in 69.0% to 80.3% of those with the condition in each setting. Nearly two thirds of those with hypertension were aware of their condition, 13% were aware but had never been treated, 13% were receiving treatment inadequate to control their hypertension, and 11% had discontinued treatment, most reporting that they had done so on the advice of their physician. Among those screened in their home, discontinuance of therapy was most often reported by those with a low income, but lack of awareness of their condition was no more prevalent in this group than in the other income groups. Efforts to control hypertension should be directed to the variety of causes of lack of control, which may occur with various frequencies in different communities, and for which screening alone may be inadequate.     

Melissotarsus ants are likely able to digest plant polysaccharides

Melissotarsus ants have an extremely specialized set of behaviours. Both workers and gynes tunnel galleries in their host tree bark. Workers walk with their mesothoracic legs pointing upwards and tend Diaspididae hemiptera for their flesh. The ants use their forelegs to plug the galleries with silk that they secrete themselves. We hypothesised that the ants’ energetic needs for nearly constant gallery digging could be satisfied through the absorption of host tree tissues; so, using basic techniques, we examined the digestive capacities of workers from two species. We show that workers are able to degrade oligosaccharides and heterosides as well as, to a lesser degree, polysaccharides. This is one of the rare reports on ants able to digest plant polysaccharides other than starch.     

Isolation and partial characterization of bean phytohemagglutinins

Extracts of seeds of 21 bean cultivars were screened for hemagglutinating specifity and for mitogenic activity. Four types could be distinguished in different beans, two of which are mitogens. Two lectin fractions (α and β) were isolated from each of the four bean types. Their MW were estimated by exclusion chromatography and component sugars by paper chromatography. Hemagglutinating activity, inhibition of hemagglutinating action by sugar-derivatives and glyco-peptides as well as mitogenic action were determined for the eight purified lectins and four control preparations. The α and β-fractions isolated from two bean types had only minimal mitogenic action, while those from the other two bean types and all of the control preparations were potent mitogens. All the mitogeric preparations agglutinated trypsin-activated cow red blood cells and pronase-activated hamster red blood cells in high dilutions but some were inactive when tested with human or rabbit red blood cells.     

Bromotyrosine-derived natural and synthetic products as inhibitors of mycothiol-S-conjugate amidase

A series of bromotyrosine-derived compounds, including marine natural products and members of a psammaplin A-inspired combinatorial synthetic library, were screened for their ability to inhibit the Mycobacterium tuberculosis detoxification enzyme mycothiol-S-conjugate amidase (MCA). Correlations between the structures and their respective IC(50) values (which range from 3 microM to 2.7 mM) should prove valuable when optimizing more potent inhibitors of MCA.     

Prevalence and spectrum of asthma in childhood.

All the 7 year old schoolchildren in North Tyneside were screened for wheeze with a questionnaire followed by selective clinical assessment: 9.3% of the children had had episodic wheeze within the past year and all those followed up subsequently responded to one or more of the drugs used for asthma. A further 1.8% had had similar symptoms since starting school, though they had not wheezed in the past year. Frequently of symptoms in the 11% of children with features of asthma varied widely and correlated with bronchial reactivity on histamine challenge, but it was not possible to separate children with frequent wheeze from asymptomatic controls by their response to histamine. It was concluded that all these wheezy children had symptoms of a common basic disorder and that they should all be treated as asthmatic.