Original Article

Part I. Digitalis Ecg. in Goldberger\u27s Augmented Unipolar Limb Leads and Wilson\u27s Unipolar Chest Leads. There were analyzed the electrocardiograms of selected 37 cases which were scrupulously observed under the digitalis therapy on account of cardiac insufficiency. 1. P. a) Goldberger\u27s leads: The changes of P are generally not striking, only 2 cases showed the significant transformation in aV_R and aV_L, respectively. b) Wilson\u27s chest leads: The changes of P in V_1〜V_6 were found only in 4 cases. 2. Cardiac position and rotation. a) Goldberger\u27s leads: No more than 2 cases gave the disjtinct changes of the cardiac position in aV leads. b) At the early stage of digitalization the clockwise rotation was more frequently seen than the anticlockwise one. 3. ST. a) Goldberger\u27s leads: ST in aV_R were tend upward and ST in aV_F downward. ST in aV_L was either raised or lowered according to the cardiac position, but these changes were for the most part within normal limits. b) Wilson\u27s chest leads: Except for the extreme right ventricular strain curve, the digitalis ST depression was markedly observed in those leads which showed the largest upward deflection of QRS. Digitalis depresses ST of the levogram, and elevates ST of the dextrogram. However both in the excessive right ventricular strain curve and in the case with vivid Halb-seiten Effekt, digitalis does not raise ST of the dextrogram. 4. T. a) Goldberger\u27s leads: T in aV_F relatively often decreases in its positivity, becomes negative, and increases in its negativity. The characteristic changes due to digitalization are not clearly recognized in aV_R and aV_L. b) Wilson\u27s chest leads: T frequently decreases in its positivity, becomes negative or diphasic, and increases in its negativity. These changes are in special measure repeatedly found in the levogram. 5. Under the digitalization ventricular premature beats, auricular flutter and fibrillation appeared in several cases. Ventricular bigeminy and atrioventricular block were observed in each of two cases.On the contrary, there were found some cases in which the digitalization extinguished ventricular extrasystoles or bigeminy and auricular fibrillation persisted so long. Even in the presence of the ventricular bigeminy which is as a rule considered to be the indication to stop the digitalis use, yet digitalis can be administered under the closed notice. 6. Among 25 cases which showed sinus full rhythm, the prolongation of PR complicated with ST depression was observed in 6 cases (24 %). 7. Among 36 cases in which QT was estimated satisfactorily, the shortening of QT was found in 17 cases (47 %); 59 % of cases with shortened QT were accompanied by ST depression. 8. The digitalis bradycardia was recognized in 18 cases (49 %) and 65 % of bradycardic cases showed ST depression. 9. In the electrocardiograms of 7 cases suffered from the side effects of digitalis, i. e. vomitting, visual disturbance and so on, there could be often found arrhythmia and distinguished ST depression. The outburst of clinical side, effects was preceded by the clear-cut ST depression in two cases, so that it may possibly be taken the onset of the remarkable ST depression granted for an alarming sign of the threatening side effects. 10. The characteristic patterns of digitalis ecg. can be recognized even in the cases with digitalis refractoriness, the extent of such changes is, however, generally less striking and becomes as slighter as near death. Part II. Experimental Studies on so-called Digitalis Ecg. The experiments were carried on the dog\u27s hearts which were relatively resistive against digitalis Cdorsal fixation, isomytal anesthesia). a) the drip infusion of 1.0 mg of Strophosid intravenously. b) 5 times of the intravenous injections of 0.25 mg of Strophosid every 20 minutes. c) 3 times of the intravenous injection of 0.6 mg of Digicorin (AD-1), in total 1.8 mg. d) the intravenous injection of 1.0 mg of Acetylcholine before and after 1.8 mg of Digicorin.e) 2 times of the intravenous injection of 0.25 mg of Strophosid after the injection of 3.6 mg of Digicorin intravenously. f) the intravenous injection of 300 mg of Pronestyl at the event ventricular tachycardia due to over dosage of digitalis. The timepoint of every observation after the various digitalis injections is always the same; at each observation, besides registration of ecg., blood pressure and respiration, Wezler\u27s analysis was performed. 1) Either Strophosid or Digicorin, which is the limit of calculated therapeutic dosage, do not bring ST-T depression, whereas the calculated toxic doses of two drugs lower ST-T distinctly. There are found some cases in which the extrasystoles are preceded by the appearance of ST-T depression; therefore it cannot be concluded that changes of ST-T pattern can be possible for guide of the digitalis bioassay. 2) In the cases injected with Strophosid fractionatedly, ST-T depression can be recognized earlier at the smaller dosis than that in the cases treated by the drip intravenous infusion. Undiluted Strophosid does often elevate the blood pressure, chiefly due to increase in output. 3) The negative chronotropic action of both Strophosid and Digicorin is more or less weak. 4) The stimulation immediately after the cervical vago-sympathectomy prolongs PR, moreover occasionally elicits atrioventricular dissociation. 5) Even in the toxic stage of Strophosid the essential pattern of carotid sinus pressor reflex can be observed, although the degree \u27of reflexibility becomes smaller than that before the injection, and the reflex tachycardia becomes more vague. From these results it may be safe to say that the effect of reflexly augmented sympathicotonia by means of Hering\u27s second stimulation is difficult to take place because of the inhibitory vagal action of Strophosid. 6) The intravenous injection, of 1.0 mg of Acetylcholine administered before the use of Digicorin lowers the blood pressure range abruptly, and there develops apnea instantly after temporal hyperpnea.Electrocardiographically after ventricular arrest due to atrioventricular block followed tachycardic auricular impure flutter, there occured initially bradicardic, thereafter tachycardic auricular fibrillation, sinus complete rhythm, temporal atrioventricular dissociation in turn untill the complete sinus rhythm was recovered. The tachycardia which breaks out at the beginning, is considered to depend upon sinocarotid or cardioaortic chemoreceptor reflex, whereas the intravenous injection of 1.0 mg of Acetylcholine after Digicorin does not cause such an initial tachycardia, so that it may be appropriate to say that Digicorin does exert influence upon these reflex arcs. 7) The intravenous injection of Acetylcholine after application of Digicorin reveals quite the same extent of the reactivity with merely one half dosis, therefore it may be concluded that Digicorin is sure to promote the vagal tonisity. 8) The intravenous injection of Acetylcholine after the administration of Tropin brings out the inverse reaction of blood pressure, whereas the hyperventilation of short duration appears. The former phenomenon may be concerned with suppression of muscarinlike action of Acetylcholine, the latter with the deficiency of the paralytic action against visceroafferent fibre. 9) After the saturation accomplished with Digicorin the intravenous injection of Strophosid depresses ST-T and further there occurs ventricular tachycardia. Even after the saturation of Digicorin, of which toxity is very slight, the injection of Strophosid proves dangerous. 10) After the, saturation by the application of Digicorin, the ventricular tachycardia due to the intravenous injection of Strophosid cannot be prevented with the administration of 300 mg of pronestyl intravenously, so the arterial depression develops. But there appeared the reduction of QRS interval which can be thought to be improvement of intraventricular conduction disturbance; therefore in such event Pronestyl proves necessary.11) All instances injected with Strophosid as above mentioned may show subendocardial haemorrhage which was observed more markedly in the outflow area beneath aortic valves than in the inflow area under mitral valves. The subendocardial haemorrhage lacked in inflammation histologically. The cases treated with the singular use of Digicorin do not show the subendocardial haemorrhage even if ST-T depressed remarkably

Influence of Socioeconomic Factors, Gender and Indigenous Status on Smoking in Taiwan.

The indigenous Austronesian minority of Taiwan is heavily affected by health disparities which may include suffering from a greater burden of the tobacco epidemic. While a lack of representative data has historically precluded an investigation of the differences in smoking between Taiwanese ethnicities, these data have recently become available through an annual population-based telephone survey conducted by the Health Promotion Administration, Ministry of Health and Welfare (previously known as the Bureau of Health Promotion (BHP), Department of Health). We used the BHP monitoring data to observe the prevalence of smoking and environmental tobacco smoke exposure among indigenous and non-indigenous Taiwanese surrounding a tobacco welfare tax increase in 2006, investigate ethnic differences in smoking prevalence and environmental tobacco smoke exposure each year between 2005 and 2008, and perform multiple logistic regression to estimate measures of association between potential risk factors and smoking status. Despite significant ethnic and gender differences in smoking prevalence, smoking status was not found to be significantly associated with ethnicity after controlling for socioeconomic and demographic factors

San-Huang-Xie-Xin-Tang Protects against Activated Microglia- and 6-OHDA-Induced Toxicity in Neuronal SH-SY5Y Cells

San-Huang-Xie-Xin-Tang (SHXT), composed of Coptidis rhizoma, Scutellariae radix and Rhei rhizoma, is a traditional Chinese herbal medicine used to treat gastritis, gastric bleeding and peptic ulcers. This study investigated the neuroprotective effects of SHXT on microglia-mediated neurotoxicity using co-cultured lipopolysaccharide (LPS)-activated microglia-like BV-2 cells with neuroblastoma SH-SY5Y cells. Effects of SHXT on 6-hydroxydopamine (6-OHDA)-induced neurotoxicity were also examined in SH-SY5Y cells. Results indicated SHXT inhibited LPS-induced inflammation of BV-2 cells by downregulation of iNOS, NO, COX-2, PGE2, gp91phox, iROS, TNF-α, IL-1β, inhibition of IκBα degradation and upregulation of HO-1. In addition, SHXT increased cell viability and down regulated nNOS, COX-2 and gp91phox of SH-SY5Y cells co-cultured with LPS activated BV-2 cells. SHXT treatment increased cell viability and mitochondria membrane potential (MMP), decreased expression of nNOS, COX-2, gp91phox and iROS, and inhibited IκBα degradation in 6-OHDA-treated SH-SY5Y cells. SHXT also attenuated LPS activated BV-2 cells- and 6-OHDA-induced cell death in differentiated SH-SY5Y cells with db-cAMP. Furthermore, SHXT-inhibited nuclear translocation of p65 subunit of NF-κB in LPS treated BV-2 cells and 6-OHDA treated SH-SY5Y cells. In conclusion, SHXT showed protection from activated microglia- and 6-OHDA-induced neurotoxicity by attenuating inflammation and oxidative stress

Does income influence rational decisions?

This study explores the impact of income on customer loyalty so as to verify whether consumer decision-making is bounded by rationality or not. The empirical findings show that income positively affects customer loyalty in choosing leisure parks. Specifically, high-income customers prefer to reduce the time cost of information collection. Therefore, they are more inclined to choose a specific resort or a leisure activity park of a particular brand rather than spend their time searching and planning for the most appropriate location of a leisure activity park. This result supports the notion that customers’ consumption decisions are bounded by rationality, not for the purpose of making the optimal decision, but in order to pursue satisfying their own needs instead

A positive feedback loop of IL-17B-IL-17RB activates ERK/β-catenin to promote lung cancer metastasis

Inflammation contributes to the development and progression of cancer. Interleukin-17 (IL-17) is an inflammatory cytokine that functions in inflammation and cancer, as well as several other cellular processes. In this study, we investigated the roles and the prognostic value of IL-17 and the IL-17 receptor (IL-17R) in lung cancer. Gene expression microarray analysis followed by Kaplan-Meier survival curve showed that IL-17B was associated with poor patient survival, and IL-17B receptor (IL-17RB) was up-regulated in lung cancer tissue compared with normal tissue. Expression of IL-17RB was associated with lymph node metastasis and distant metastasis, as well as poor patient survival. IL-17RB overexpression significantly increased cancer cell invasion/migration and metastasis in vitro and in vivo. IL-17RB induced ERK phosphorylation, resulting in GSK3β inactivation and leading to β-catenin up-regulation. IL-17RB also participated in IL-17B synthesis via the ERK pathway. IL-17RB activation is required for IL-17B-mediated ERK phosphorylation. Taken together, IL-17B-IL-17RB signaling and ERK participate in a positive feedback loop that enhances invasion/migration ability in lung cancer cell lines. IL-17RB may therefore serve as an independent prognostic factor and a therapeutic target for lung cancer

Mineralization of Progenitor Cells with Different Implant Topographies

AbstractThe major challenge for dental implants is achieving an optimal osteoregeneration. Different levels of roughness processed through sand-blasting/ acid-etching (SLA) then further treated with silane and peptide were measured. Peptide bonded with silane on the SLA and machine ground titanium (Ti) surface were used as a culture substitute. The sample properties on the osteogenic abilities were compared by testing the interaction with mesenchymal stem cells (MSCs, D1). When comparing to the SLA only group, the silane treated Ti surface with peptide bonded had smaller wetting angle and the cell proliferative ability did differ with statistical significance (p<0.05). A rougher surface binding with peptide provided higher hydrophilic ability and had the potential ability to enhance the proliferation and mineralization of the progenitor cell D1. Accordingly, a novel implant surface treatment method having tissues integrated was obtained through the supplement of peptide on the surfaces through SLA treatment of titanium

A powerful and efficient multivariate approach for voxel-level connectome-wide association studies

We describe an approach to multivariate analysis, termed structured kernel principal component regression (sKPCR), to identify associations in voxel-level connectomes using resting-state functional magnetic resonance imaging (rsfMRI) data. This powerful and computationally efficient multivariate method can identify voxel-phenotype associations based on the whole-brain connectivity pattern of voxels, and it can detect linear and non-linear signals in both volume-based and surface-based rsfMRI data. For each voxel, sKPCR first extracts low-dimensional signals from the spatially smoothed connectivities by structured kernel principal component analysis, and then tests the voxel-phenotype associations by an adaptive regression model. The method's power is derived from appropriately modelling the spatial structure of the data when performing dimension reduction, and then adaptively choosing an optimal dimension for association testing using the adaptive regression strategy. Simulations based on real connectome data have shown that sKPCR can accurately control the false-positive rate and that it is more powerful than many state-of-the-art approaches, such as the connectivity-wise generalized linear model (GLM) approach, multivariate distance matrix regression (MDMR), adaptive sum of powered score (aSPU) test, and least-square kernel machine (LSKM). Moreover, since sKPCR can reduce the computational cost of non-parametric permutation tests, its computation speed is much faster. To demonstrate the utility of sKPCR for real data analysis, we have also compared sKPCR with the above methods based on the identification of voxel-wise differences between schizophrenic patients and healthy controls in four independent rsfMRI datasets. The results showed that sKPCR had better between-sites reproducibility and a larger proportion of overlap with existing schizophrenia meta-analysis findings. Code for our approach can be downloaded from https://github.com/weikanggong/sKPCR. [Abstract copyright: Copyright © 2018 Elsevier Inc. All rights reserved.

Clinical Practice of Endoscopic Submucosal Dissection for Early Colorectal Neoplasms by a Colonoscopist with Limited Gastric Experience

Objectives. Endoscopic submucosal dissection (ESD) for early colorectal neoplasms is regarded as a difficult technique and should commence after receiving the experiences of ESD in the stomach. The implementation of colorectal ESD in countries where early gastric cancer is uncommon might therefore be difficult. The aim is to delineate the feasibility and the learning curve of colorectal ESD performed by a colonoscopist with limited experience of gastric ESD. Methods. The first fifty cases of colorectal ESD, which were performed by a single colonoscopist between July 2010 and April 2013, were enrolled. Results. The mean of age was 64 (±9.204) years with mean size of neoplasm at 33 (±12.63) mm. The mean of procedure time was 70.5 (±48.9) min. The rates of en bloc resection, R0 resection, and curative resection were 86%, 86%, and 82%, respectively. Three patients had immediate perforation, but no patient developed delayed perforation or delayed bleeding. Conclusion. Our result disclosed that it is feasible for colorectal ESD to be performed by a colonoscopist with little experience of gastric ESD through satisfactory training and adequate case selection

Effect of prolonged HAART on oral colonization with Candida and candidiasis

BACKGROUND: Progressive cell-mediated immunodeficiency with decrease of CD4+ lymphocyte count to less than or equal to 200 cells/mm(3 )is a major risk factor for colonization with Candida species and development of candidiasis. Oropharyngeal candidiasis may occur in up to 90% of human immunodeficiency virus (HIV)-infected patients during the course of the disease. This study is to determine the effect of prolonged highly active antiretroviral therapy (HAART) on oropharyngeal colonization with Candida species and oral candidiasis. METHODS: A prospective, longitudinal follow-up study in HIV-infected patients receiving HAART. RESULTS: The mean CD4+ count increased from 232.5 to 316 cells/mm(3 )and the proportion of patients whose CD4+ count less than 200 cells/mm(3 )decreased from 50.0% to 28.9% (p = 0.0003) in patients receiving HAART for at least 2 years. The prevalence of oral candidiasis decreased from 10.6% to 2.1% (p = 0.004). The decrease in Candida colonization was less impressive, falling from 57.8% to 46.5 % (p = 0.06). Of the 142 patients enrolled in at least two surveys, 48 (33.8%) remained colonized with Candida and 42 (29.6%) remained negative. In the remaining 52 patients, 34 switched from culture positive to negative, and an increase in CD4+ lymphocytes was noted in 91.2% of them. Among the 18 patients who switched from culture negative to positive, 61.1% also demonstrated an increase in CD4+ lymphocyte count (p = 0.01). CONCLUSION: These findings indicate that HAART is highly effective in decreasing oral candidiasis in association with a rise in CD4+ lymphocyte counts, but only marginally effective in eliminating Candida from the oropharynx