UNASSIGNED

To investigate the relationship between the serum anti-Müllerian hormone (AMH) level and semen parameters.

METHODS

We collected the data about 726 outpatients at the Male Infertility Clinic of Jinling Hospital from September 2015 to November 2016, including 72 with non-obstructive azoospermia, 123 with oligospermia, and 531 with normal sperm concentration. We obtained the semen volume, total sperm count, sperm concentration, sperm motility, the percentages of progressively motile sperm (PMS) and morphologically normal sperm (MNS), and the levels of serum AMH, inhibin B (INH-B), total testosterone (TT) and follicle - stimulating hormone (FSH) of the patients, analyzed the correlation of the serum AMH level with the other parameters, and compared the AMH level among different groups.

RESULTS

The serum AMH level was found to be correlated positively with the total sperm count (r = 0.227, P <0.001), sperm concentration (r = 0.215, P <0.001), sperm motility (r = 0.111, P = 0.003), the percentage of PMS (r = 0.120, P = 0.001), and the levels of INH-B (r = 0.399, P <0.001) and TT (r = 0.184, P = 0.002), negatively with the FSH level (r = －0.283, P <0.001), but insignificantly with age, time of abstinence, semen volume, and the percentage of MNS (P >0.05). There was a statistically significant difference in the serum AMH level among the patients with non-obstructive azoospermia, oligozoospermia, and normal sperm concentration (［6.33 ± 4.26］ vs ［8.26 ± 3.98］ vs ［9.8 ± 5.19］ ng/ml, P <0.001).

CONCLUSIONS

Serum AMH is a biomarker reflecting the function of Sertoli cells and its level is significantly correlated with sperm concentration and motility, suggesting that AMH may be involved in spermatogenesis and sperm maturation.

The best prevention of the aspiration syndrome begins with early identification of any patient at risk. Reduction of gastric volume and elevation of gastric pH can be achieved by premedication with glycopyrrolate (0.3 mg i.m.) and preoperative administration of H2-receptor antagonists (150 mg ranitidine p.o. 6-8 h and 80 mg i.m./i.v. 60 min before induction). Transportation of stomach contents into the duodenum can further be accelerated by 10 mg metoclopramide i.v. 20-40 min before induction. Metoclopramide will also elevate lower esophageal sphincter tone. Rapid elevation of gastric pH can be achieved by oral administration of 15-30 ml 0.3 mol sodium citrate. Induction of anesthesia should be performed as a "rapid sequence induction". Manual compression of the esophagus (Sellick manoever) may prevent gastric regurgitation. In cases of pulmonary aspiration, consequent therapy has to be initiated as soon as possible to limit broncho-alveolar damage. After endotracheal intubation the upper respiratory tract should be cleared of stomach contents by suction. Further efforts should include artificial ventilation with a high FiO2 and low PEEP (5-10 cm H2O) as well as vigorous volume substitution to maintain cardiovascular stability. Corticosteroids (200 mg Hydrocortisone i.v. may have a beneficial effect if given within 5 min after aspiration. Severe bronchospasm may respond to aminophylline (5 mg/kg i.v. as an initial bolus) or inhalation of beta-adrenergics (terbutaline 0.75-1.5 mg/inh). Bronchial lavage will rather damage than improve broncho-alveolar integrity and cannot be recommended.(ABSTRACT TRUNCATED AT 250 WORDS)

A 14-y-old bay Quarter Horse gelding was presented with progressive neurologic signs, elevated rectal temperature, and icterus for 3 d prior to death. Postmortem examination revealed icterus, large amounts of serosanguineous fluid in the abdominal cavity, widespread petechiae and ecchymoses in several organs, and a large, pale, and well-demarcated focus of necrosis in the liver. Histologically, there was coagulative necrosis surrounded by a rim of inflammatory cells and large numbers of gram-positive rods, which were identified as Clostridium novyi by immunohistochemistry. Liver samples tested by PCR were positive for C. novyi type B flagellin and alpha toxin genes, but negative for Clostridium haemolyticum and other clostridia. Based on postmortem findings and ancillary tests, a definitive diagnosis of infectious necrotic hepatitis (INH) was made. Mostly a disease of ruminants, also known as black disease, INH has rarely been reported in horses, and a definitive etiologic diagnosis has not been achieved previously; the etiology of all cases reported to date was identified as C. novyi but the type was not determined. Animals are predisposed to clostridial hepatitis when hepatic anaerobiosis is established. Such conditions allow germination and proliferation of bacterial spores, resulting in production and release of toxins. INH, caused by C. novyi type B, and bacillary hemoglobinuria, caused by C. haemolyticum, are mechanistically and pathologically almost indistinguishable. Because these 2 microorganisms are closely related, differentiation requires molecular tools.

Acquired angioedema due to C1 inhibitor deficiency (C1-<em>INH</em>-AAE) is characterized by recurrent edema of the subcutaneous and/or submucosal tissue without wheals and negative family history of angioedema. Here, we present the case of a patient with a chronic lymphatic <em>B</em> cell leukemia who suffered from both C1-<em>INH</em>-AAE and chronic spontaneous urticaria. Oral corticosteroids, antihistamines, and the anti-IgE antibody omalizumab were applied to treat the chronic urticaria in combination with the plasma-derived C1 esterase inhibitor concentrate <em>B</em>erinert® and the bradykinin <em>B</em>2 receptor antagonist icatibant, but the symptoms did not improved significantly. Thus, polychemotherapy targeting the slow-growing lymphoproliferative disease including rituximab was initiated, which resulted in remission of both the urticaria and the angioedema.

In the airway, Cl^- is the most a<em>b</em>undant anion and is critically involved in transepithelial transport. The correlation of the a<em>b</em>normal expression and activation of chloride channels (CLCs), such as cystic fi<em>b</em>rosis transmem<em>b</em>rane conductance regulators (CFTRs), anoctamin-1, and CLC-2, with cell migration capa<em>b</em>ility suggests a relationship <em>b</em>etween defective Cl^- transport and epithelial wound repair. However, whether a correlation exists <em>b</em>etween intracellular Cl^- and airway wound repair capa<em>b</em>ility has not <em>b</em>een explored thus far, and the underlying mechanisms involved in this relationship are not fully defined. (<em>b</em>)Methods:</<em>b</em>) In this work, the alteration of intracellular chloride concentration ([Cl^-]<su<em>b</em>)i</su<em>b</em>)) was measured <em>b</em>y using a chloride-sensitive fluorescent pro<em>b</em>e (N-[ethoxycar<em>b</em>onylmethyl]-6-methoxyquinolium <em>b</em>romide). (<em>b</em>)Results:</<em>b</em>) We found that clamping with high [Cl^-]<su<em>b</em>)i</su<em>b</em>) and 1 h of treatment with the CLC <em>inh</em>i<em>b</em>itor CFTR <em>b</em>locker CFTR<su<em>b</em>)<em>inh</em></su<em>b</em>)-172 and chloride intracellular channel <em>inh</em>i<em>b</em>itor IAA94 increased intracellular Cl^- concentration ([Cl^-]<su<em>b</em>)i</su<em>b</em>)) in airway epithelial cells. This effect improved epithelial cell migration. In addition, increased [Cl^-]<su<em>b</em>)i</su<em>b</em>) in cells promoted F-actin reorganization, decreased cell stiffness, and improved RhoA activation and LIMK1/2 phosphorylation. Treatment with the ROCK <em>inh</em>i<em>b</em>itor of Y-27632 and ROCK1 siRNA significantly attenuated the effects of increased [Cl^-]<su<em>b</em>)i</su<em>b</em>) on LIMK1/2 activation and cell migration. In addition, intracellular Ca²⁺ concentration was unaffected <em>b</em>y [Cl^-]<su<em>b</em>)i</su<em>b</em>) clamping <em>b</em>uffers and CFTR<su<em>b</em>)<em>inh</em></su<em>b</em>)-172 and IAA94. (<em>b</em>)Conclusion:</<em>b</em>) Taken together, these results suggested that Cl^- accumulation in airway epithelial cells could activate the RhoA/ROCK/LIMK cascade to induce F-actin reorganization, down-regulate cell stiffness, and improve epithelial migration.

Keywords: Airway epithelial cells; Cell stiffness; Epithelial migration; Intracellular chloride; MQAE.

The syndrome of acquired angio-oedema is characterized by late onset of recurrent bouts of angio-oedema or abdominal pain and may be caused by an acquired deficiency of C1-inhibitor (C1-INH), the inhibitor of the first component of complement. Acquired C1-INH deficiency has been described in approximately 50 patients and is strongly associated with malignant B-cell proliferations. We describe a patient with an 8-year history of recurrent abdominal symptoms and angio-oedema with acquired C1-INH deficiency, caused by the presence of IgA-kappa antibodies that inactivate C1-INH. Analysis of the bone marrow revealed an IgA-kappa monoclonal population of plasma cells, without evidence of overt myeloma. Angio-oedema caused by an autoantibody of the IgA isotype is extremely rare and has never been described in a Dutch patient. Recognition of angio-oedema, both hereditary and acquired, is important because of the therapeutic consequences, as will be discussed.

During agarose electrophoresis C4 in the normal human serum is converted into cleavage products of Beta 1 and Beta 2 mobility. By contrast in the serum of untreated patients with hereditary angiodema C4 gives only one Beta 2 peak on crossed immunoelectrophoresis. The normal C4 electrophoretic pattern is restored in serum of patients treated with stanazolol but not with danazol despite the same C1-esterase inhibitor (C1 INH) activities and C4 serum concentration. We suggest that stanazolol besides having specific effect on C1 INH activity can interfere with other protease inhibitors affecting C1 activation.

Background: Multiple studies have uncovered the effects that ingested fat has on human blood levels of testosterone. Yet, few reports have discussed the effect of circulating serum free fatty acids (FFAs). The present study aimed to explore the relationship between serum free fatty acids and blood levels of testosterone.

Methods: In total, 5719 adults were pooled from the database of the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2012. Based on multivariable-linear regression models, we employed a total of 30 FFAs to interpret the relationship of FFAs with blood levels of testosterone. Two models with covariate adjustments were designated for further evaluation and analysis.

Results: Capric acid [β = -0.014, 95% confidence interval (CI) = -0.023, -0.004, P = 0.005], myristic acid (β = -0.001, 95% CI = -0.001, 0.000, P ≤ 0.001), pentadecanoic acid (β = -0.013, 95% CI = -0.018, -0.008, P ≤ 0.001), margaric acid (β = -0.011, 95% CI = -0.017, -0.005, P ≤ 0.001) and alpha-linolenic acid (β = -0.001, 95% CI = -0.002, 0.000, P = 0.004) in the fully adjusted model were significantly negatively correlated with the testosterone level inh obese men. In the fully adjusted model for the female analysis, myristic acid, pentadecanoic acid, palmitic acid, margaric acid, stearic acid, myristoleic acid, oleic acid, nervonic acid and alpha-linolenic acid were found significantly associated with the testosterone level.

Conclusions: Our findings indicate a significant negative correlation between serum FFAs and blood levels of testosterone. Furthermore, we reveal the essentiality of serum FFAs and their potential effects on the reduction of testosterone levels.

Keywords: dietary fat; fat; obesity; serum; serum free fatty acids; testosterone.

Purpose of this retrospective study was to investigate if serum markers, men's age, interval since vasectomy, BMI, testicular size and smoking could predict the success of epididymal or testicular sperm aspiration (PESA/TESA) in vasectomized men. Forty-four consecutively performed PESA/TESA procedures were reviewed retrospectively. Motile sperm was retrieved from 77.3% of PESA/TESA procedures. Mean serum Inhibin-B (Inh-B) level tended to be higher in men who had motile sperm retrieved compared to those who had not (180.3 versus 126.2 pg/ml, p = 0.05). Univariate analysis identified serum Inh-B to be the only predictor of PESA/TESA success (r = 0.32, CI: 0.006-0.584, p = 0.046). Serum FSH, LH, T levels, age, BMI, smoking status and interval since vasectomy did not correlate with the PESA/TESA outcome. Inh-B could modestly discriminate between successful and unsuccessful PESA/TESA (AUC= 0.70) with high positive (89.5%) but low negative prediction (36.8%); 58.6% sensitivity and 77.7% specificity at the optimum cut-off level of 166 pg/ml. Positive outcome was only 50% when the Inh-B level was below 100 pg/ml. It is concluded that a high serum Inh-B might reliably predict successful PESA/TESA in vasectomized men. More invasive sperm retrieval procedures could be reserved for men with very low Inh-B or failed PESA/TESA. Future studies with adequate power may confirm our findings.

BACKGROUND

Debates about equity in the utilization of health services often omit whether inequalities are observed in effective and safe procedures or they are experienced in treatments dubiously effective. This work tries to illustrate the difference between inequality and inequity in the health services research field.

METHODS

Ecologic study on the standardized rates of surgical interventions in uterus and prostate cancer, produced between 2002 and 2004 in 180 healthcare areas in Spain. Socioeconomic variables: public beds per 100,000 inh, economic level, unemployment rate (population between 25 and 49), bank offices per 1,000 inh., and proportion of illiterate or persons with no studies. To estimate inequality statistics for Small Area Analysis were used; to determine the effect of socioeconomic factors, ANOVA and Linear Multiple Regression were modelled.

RESULTS

12,178 admissions for hysterectomy (2.19 per 10,000 women) and 13,416 prostatectomies (2.47 per 10,000 men) were analysed. All the statistics showed higher variation (inequality) in prostate cancer. Hysterectomy rates were not related with socioeconomic factors as oppose as prostatectomy: higher rates were related with living in areas with bigger centres (beta=0.89, p <0.001), with more economic level (beta=0.72, p=0.004) and less rate of illiterate persons (with regard to the tertile, betat2 = 0.75, p=0,002; betat3 = 0.57, p=0,044).

CONCLUSIONS

Inequalities in the utilization of healthcare services do not necessarily imply inequity. In prostatectomy due to prostate cancer, an uncertain procedure in terms of effectiveness, the observed inequalities against poorer areas, should not be interpreted as a symptom of inequity.

Glutamic oxaloacetic transaminase (EC 2.6.1.1), has been prepared from the liver of Hausa he-goat (Capra hircus). 2. Gel filtration of the liver extract presents evidence of two molecular species of the enzyme; one species (Fraction A) has a specific activity of 280 U/mg protein and the other (Fraction B) has a specific activity of 338 U/mg protein. 3. Fraction A has optimum activity at pH 6.8 and Fraction B is optimally active at pH 5.5. The observed variation in activity with pH variation may be due to ionisation of some group(s) on the enzyme. 4. Characteristic spectral changes typical of INH/GOT interactions at low and high pH values are presented. 5. Typical Dixon's plot indicates a competitive inhibition of the enzyme by INH. Ki and Km of 0.04 and 2.5 mM for Fraction A and Ki and Km of 0.098 and 4.7 mH for Fraction B have been calculated from the data. 6. These results have been discussed in the light of the properties of the enzyme from other sources.

OBJECTIVE

To explore the differences in the expression of inhibin (INH) receptors and activin (ACT) receptors in the follicular/luteinic phase in normal human ovaries and their relationship with female endocrine hormone levels.

METHODS

Real time PCR and immunohistochemistry were used to determine the expression of inhibin receptors (INHR) genes, activin receptors (ACTR) genes. Serum estradiol (E2), follicle stimulating hormone (FSH), luteinizing hormone (LH), INHB, ACTA levels were determined by a solid quantitative sandwich enzyme immunoassay technique (Sandwich ELISA) in 21 women during follicular phase and another 21 women during luteinic phase, the correlations between each gene and each hormone were analyzed.

RESULTS

(1) ACT type I and II receptors genes (ACTR I A, ACTR I B, ACTR II A, ACTR II B) and INH receptor beta-glycan genes were expressed higher in the follicular phase than in the luteinic phase: ACTR I A (0.50 +/- 0.17 vs 0.36 +/- 0.18; P < 0.05), ACTR I B (0.050 +/- 0.019 vs 0.036 +/- 0.020; P < 0.05), ACTR II A (0.10 +/- 0.04 vs 0.07 +/- 0.04; P < 0.05), ACTR II B (0.28 +/- 0.10 vs 0.19 +/- 0.11; P < 0.05), beta-glycan (0.26 +/- 0.10 vs 0.17 +/- 0.09; P < 0.01). (2) The intensities of ACTR I A, ACTR II A, beta-glycan immunostaining in human normal ovaries in the follicular phase were significantly stronger compared to those in luteinic phase. In the follicular phase beta-glycan expression was positively correlated with serum E2, FSH, LH, INHB levels. The correlation coefficient was 0.53 (P < 0.05), 0.74 (P < 0.01), 0.85 (P < 0.01) and 0.76 (P < 0.01) respectively.

CONCLUSIONS

In normal human ovary in the follicular phase INH and ACT bind their receptors and down-regulate or up-regulate FSH, thus influencing the follicular development.

The ability of macrophage colony-stimulating factor (M-CSF) to influence production of complement proteins by cultured human monocytes was studied. Three-day-old cultures of human monocytes were treated with 250-1000 U/ml recombinant human M-CSF (Cetus Corporation, Emeryville, CA). After 3 days the M-CSF containing medium was replaced by the same medium without M-CSF, and the cells were cultured for 3 more days. Samples taken at the removal of M-CSF and 3 days later were tested for the concentration of factor B and Cl-esterase inhibitor (Cl-INH) using ELISA methods, and C2 by using an immunohaemolytic assay. M-CSF induced a marked dose-dependent increase in the synthesis of Cl-INH, but did not significantly change Bf and C2 production. The findings suggest that M-CSF is able to influence selectively the complement protein-producing ability of cultured human monocytes.

The fundamental new universal method of evaluation of the interaction between macroradical and radioprotector (the access window method) is presented here. It's based on the modelling phenomenon of molecule penetration to the active centre of macromolecule structure through the functional groups free "window". The steric modelling of the B-DNA structure fragments allowed to measure the conformation parameters of the intermediate stereocomplex between interacting substancies. Using the thesis about molecule InH mask the interaction process of InH (steric hindered phenol 4-oxy-3,5-di-tret-butyl-alpha-metylbenzylamine, mercaptoethanol, MET, and L-cysteine, CYS) with 2-deoxyribosyl five radicals in DNA was studied. It was determined, that the radioprotection maximum effect on single-strand breakage formation in irradiated cell can reach 2/3 of the total sugar radicals yield and for MET and CYS (with minor mask squares) -87.5, and 91%, accordingly (it agrees with experiment in literature data).

This review deals with the new generation of selective and partly reversible monoamine oxidase (MAO) inhibitors. In contrast to the non selective inhibitors, used in the year 1957-1970, the selective inhibitors bind to and block only one of the two isoenzymes, MAO-A or MAO-B. The MAO-A inhibitors and part of the MAO-B inhibitors differ also from the classic drugs by their reversibility. The inhibition of MAO-A cause the rise of norepinephrine, dopamine and serotonin in the synaptic cleft, of MAO-B only of dopamine. The new inhibitors diminish also to some extent the reuptake of monoamines. The molecular action mechanism of the new drug generation is the same as in the non-selective drugs: increase of monoamines, near to the receptor, leads, after a number of intermediate steps, to activation of functional proteins in the cell. The selective block of one of the isoenzymes does not stop the metabolism of tyramine (from cheese, red wine), because this toxic compound is metabolised by both isoenzymes. The control of therapy with MAO-A inhibitors is easier, because of their reversibility. Selective inhibitors of MAO have found a secure place in therapy of depression (inh. of MAO-A, esp. Moclobemide) and Parkinson's disease (inh. of MAO-B, at this time mainly selegiline). Discussed is possible use of selective MAO-inhibitors for achieving an increase in cognitive function and protections of neurone cells from biochemical lesions.

Previously, we showed that ovarian inhibin α- and β;(A)-subunit mRNAs are elevated in middle-aged and old persistent-estrous (PE) female rats. To determine whether higher inhibin subunit mRNA expressions result in increased circulating inhibins during reproductive aging, plasma immunoreactive inhibin α (ir-inh α) and gonadotropins were measured in young, middle-aged and PE rats. Plasma LH profiles were distinctly divergent in the middle-aged rats with some showing LH surges indistinguishable from young rats and others showing significantly attenuated LH surges. Plasma ir-inh α in middle-aged rats with LH surges were similar to those of young rats. However, animals with attenuated LH surges had higher peak ir-inh α levels than young and middle-aged animals with LH surges. Immunohistochemistry revealed increased levels of ovarian inhibin α staining in those animals with attenuated LH surges. Overall, the highest plasma and ovarian inhibin α were found in PE rats which lack LH surges. However, significant decreases of plasma and ovarian inhibin α were seen after reinstatement of estrous cyclicity with progesterone implant treatment. Thus, increases in both plasma and ovarian inhibin α appear to be closely associated with attenuation or loss of the preovulatory gonadotropin surge that occurs during aging.

Inhibin (INH), oestradiol (E2) and progesterone (P) were measured in the follicular fluid (FF) of 22 patients 28-38 years old (Group A) and 11 patients 43-47 years old (Group B) who had received gonadotrophin stimulation in an in vitro fertilization and embryo transfer (IVF-ET) programme. The results indicated that INH, E2 and P levels were significantly lower and the E2/P ratio was higher in FF of Group B patients (older women) compared to those of Group A. There were six single pregnancies among patients of Group A. No difference was observed in follicular fluid INH, E2 and P levels as well as in E2/P ratio between pregnant and non-pregnant patients of Group A (Group A1 and Group A2, respectively). A positive correlation was found between FF concentrations of E2 and P, E2 and INH and P and INH in the three Groups and a negative one between INH and the E2/P ratio in Group B. It seems likely that ovarian INH and E2 production are controlled by different mechanisms and that INH response to ovarian hyperstimulation is altered by advancing age.

(<em>b</em>)<i>Background:</i></<em>b</em>) The understanding of the real flow profiles through a dry powder <em>inh</em>aler (DPI), generated <em>b</em>y asthma patients, is a prerequisite for satisfactory drug delivery to the lungs. The aims of the study were to assess the relationship <em>b</em>etween spirometric measures and <em>inh</em>alation profiles through a low-resistance DPI, and to compare parameters of those profiles <em>b</em>etween optimal and su<em>b</em>optimal <em>inh</em>alation technique type. (<em>b</em>)<i>Methods:</i></<em>b</em>) Both healthy adult volunteers and patients with asthma were included in the study. Spirometry was conducted along with modified flow-volume test to detect expiratory levels (maximum "100%" exhalation to residual volume [RV] and halfway "50%" to RV). These were the reference levels of the depth of exhalation for each patient to simulate the effect of incomplete exhalation. Individual <em>inh</em>alation profiles were recorded using spirometry in-house software as the volumetric airflow through the <em>inh</em>aler versus time. Inspiratory flow parameters were extracted: time to peak inspiratory flow through <em>inh</em>aler (PIF<su<em>b</em>)<em>inh</em></su<em>b</em>)), time at which peak inspiratory flow occurs (tPIF<su<em>b</em>)<em>inh</em></su<em>b</em>)), total <em>inh</em>alation time (T), and <em>inh</em>aled volume during maneuver (V). (<em>b</em>)<i>Results and Conclusions:</i></<em>b</em>) There are significant relationships <em>b</em>etween spirometric indices and parameters of <em>inh</em>alation through a low-resistance, cyclohaler-type DPI (assessed <em>b</em>y single-factor analysis of Spearman's rank correlation coefficient). Multiple regression models were constructed, predicting inspiratory flow parameters (including spirometric indices, demographic parameters, and <em>inh</em>aler's usage history as determinants). The exhalation halfway to RV <em>b</em>efore <em>inh</em>alation did not affect significantly PIF<su<em>b</em>)<em>inh</em></su<em>b</em>) and tPIF<su<em>b</em>)<em>inh</em></su<em>b</em>) (and, thus, initial flow dynamics) in asthma patients. T and V parameters were then significantly decreased, <em>b</em>ut seemed sufficient for successful DPI performance. Both exhalation to RV and incomplete exhalation halfway to RV preceding <em>inh</em>alation allow for effective usage of low-resistance DPI.

Keywords: asthma; dry powder inhaler; inhalation profile; inhalation technique; inspiratory flow parameters; spirometry.

An attack treatment with 3 drugs during 4-6 months and a consolidation treatment with 2 drugs then INH was applied in 595 cases detected between July 1, 1968 and June 30, 1972, i.e. 264 group A (positive), 200 group B (negative cultures) and 131 group C (pleuretics). The contacts had been in close contact with the source for at least three months before establishing the diagnosis; 549 had been vaccinated at birth with BCG and 209 revaccinated; 413 had undergone chemoprophylaxis with INH. The control group comprised 1008 subjects, the mean age of the groups being very close; they were followed up for 2 years and 1 month and 2 years and 7 months. Testing was done every year with 1 u PPD IC 65. The contacts were controlled annually by radiophotography and X-ray and the controls only in case of shifting of the test. Among the contacts there were 44 conversions in the subjects with an initial tuberculin reaction of 0-5 mm and 4 in those with an initial tuberculin reaction of 6-9 mm, representing 15.1% (group A 27.7%, group B 9,8%, group C 10.5%). Three months after the initiation of chemotherapy the proportion of conversions in the three groups (group A 12.3%, group B 5.9%, group C 10.5%) was equal to that of the controls (8.8%). The next year there were 11.2% conversions among the contracts (group A 11.4%, group B 9.6% and C 17.7%) as against 11.9% among the controls. In the first year 8.3% of the contacts contracted tuberculosis (A 15.6%, B 2.4%, C 4.0%) and 0.32% of the controls. The next year 2.8% of the contacts fell ill (A 4.3%, B 2%, C 0%) and 0.5% of the controls. Among group A contacts aged 0 to 6 years there were 31.7% conversions and 30.7% cases of tuberculosis in the first year, and 7.1% and 1.8% respectively in the following year. Group B and C presented 10.9% conversions and 6% cases of disease in the first year, and no case of tuberculosis in the second year. Chemotherapy reduced conversions and sickness in this group three months after the diagnosis was established.

A total of 377 cases with primarily treated bacillary tuberculosis selected from 432 patients admitted to 5 major national sanatoria during 1987 was analysed and compared with the same sort of studies done in national sanatoria in 1976 and 1980, and in addition 21 dead cases were investigated. The results were as follows. 1. 110 cases (29%) were over 60 years of age. 2. New intensive regimens containing INH and RFP has become popular (over about 70%). 3. The duration of chemotherapy has been shortened (65% terminated within 12 month, while only 9.5% in 1980). 4. The duration of admission has been shortened (65% discharged within 6 month, while 59% 1980). 5. 21 dead cases were in the higher age group (70% were over 60 years of age) and the higher rate of complications including diabetes mellitus (28%), cancer (21%) and heart failure (19%). 6. At the start of chemotherapy, chest X-ray showed fresh types of GAKKEN A & B in 307 cases (82%) and cavitary type of GAKKAI I & II in 274 cases (73%) and these proportions have not changed since 1980 and the response to chemotherapy was as good as in 1980. Based on the above findings, the older age patients with various complications might be regarded as the most difficult cases to be cured at present in coming years.

<p><div>(<em>b</em>)Background</<em>b</em>)</div>Among different resistance mechanisms in <i>Myco<em>b</em>acterium tu<em>b</em>erculosis</i> (MTB), efflux pumps may have a role in drug-resistance property of MTB. So, the aim of this study was to compare the relative overexpression of two important efflux pump genes, <i>drrA</i> and <i>drrB</i>, among MTB isolates from TB patients.</p><p><div>(<em>b</em>)Methods</<em>b</em>)</div>A total of 37 clinical isolates of confirmed MTB isolates were analyzed. Drug suscepti<em>b</em>ility testing (DST) was performed using the conventional proportional method. Real-time semiquantitative PCR profiling of the efflux pump genes of <i>drrA</i> and <i>drrB</i> was performed for clinical isolates. The receiver operating curve (ROC) analysis for differentiation of resistant from suscepti<em>b</em>le isolates on the <em>b</em>asis of efflux pump expression fold changes was also performed.</p><p><div>(<em>b</em>)Results</<em>b</em>)</div>According to DST, 16 rifampin (RIF) monoresistant, 3 isoniazid (<em>INH</em>) monoresistant, 5 multidrug-resistant (MDR) and 13 pan-suscepti<em>b</em>le isolates of MTB were evaluated for gene expression. The highest values of <i>drrA</i> and <i>drrB</i> gene expression fold changes were seen in MDR isolates, which were significant in comparison with suscepti<em>b</em>le isolates and H37Rv reference strain. By using comparative ROC analysis, the o<em>b</em>tained cutoff point for <i>drrA</i> and <i>drrB</i> gene overexpression was the folds of >1.6 and >2.3, respectively.</p><A<em>b</em>stractText>The results of the present study confirm the role of DrrA-DrrB efflux pump in anti<em>b</em>iotic resistance in clinical MTB isolates. As the large num<em>b</em>er of efflux pumps are located in the cell envelope of MTB, we cannot correlate a single efflux pump overexpression to the drug-resistance phenotype, unless all the pumps simultaneously investigated.</A<em>b</em>stractText>

Anionic conjugated polymer (PFP-SO 3-) was assembled with a novel enzymatic substrate 6-O-modified PNP-β-galactoside (1) for sensitive multiplex enzyme detections. The PFP-SO 3-/1/lipase/β-galactosidase system has two chemical input signals which are Input 1 (lipase) and Input 2 (β-galactosidase), and output optical signals such as fluorescence emission at 416 nm or 450 nm. Four types of logic gates, including YES, INH, NAND and AND, were successfully constructed and utilized for multiplex detections of lipase and β-galactosidase in one tube.